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General NPI Number Information
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NPI Number | 1083901094
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Entity Type | Individual
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Provider Name | HANANE N HAIDAR-AHMAD PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 06/29/2011
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Last Update Date | 06/29/2011
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Provider Practice Location Address
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Address Line | 35401 WARREN RD
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City | WESTLAND
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State | MI
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Zip | 48185-6590
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Country | US
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Telephone | 734-728-6031
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Fax |
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Provider Business Mailing Address
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Address Line | 26205 SHEAHAN DR
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-4117
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Country | US
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Telephone | 313-587-4030
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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 | 5302031530
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License Number State | MI
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