Healthcare Provider Details

I. General information

NPI: 1477261485
Provider Name (Legal Business Name): ALI HASSAN ZAGHIR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2022
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 FORT ST
WYANDOTTE MI
48192-3841
US

IV. Provider business mailing address

7331 PINEHURST ST
DEARBORN MI
48126-1564
US

V. Phone/Fax

Practice location:
  • Phone: 734-283-9640
  • Fax:
Mailing address:
  • Phone: 313-358-8393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302414816
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: