=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114349800
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MOHAMMED UDDIN
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/14/2014
-----------------------------------------------------
Last Update Date | 12/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9740 CONANT ST SUITE 3
-----------------------------------------------------
City | HAMTRAMCK
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48212-3307
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-875-7979
-----------------------------------------------------
Fax | 313-875-4620
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9740 CONANT ST SUITE 3
-----------------------------------------------------
City | HAMTRAMCK
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48212-3307
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-875-7979
-----------------------------------------------------
Fax | 313-875-4620
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 5301008559
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------