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General NPI Number Information
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NPI Number | 1043895337
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Entity Type | Individual
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Provider Name | MARIEM ADNAN FARAJ
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Gender | Female
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Dates
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Enumeration Date | 03/17/2021
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Last Update Date | 03/17/2021
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Provider Practice Location Address
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Address Line | 9300 JOSEPH CAMPAU ST
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City | HAMTRAMCK
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State | MI
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Zip | 48212-3434
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Country | US
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Telephone | 313-874-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 5517 MIDDLESEX ST
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City | DEARBORN
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State | MI
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Zip | 48126-5021
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Country | US
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Telephone | 313-510-6411
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302412080
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License Number State | MI
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