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General NPI Number Information
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NPI Number | 1184240699
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Entity Type | Individual
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Provider Name | NASHWA GERGES-HENAN PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 06/20/2020
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Last Update Date | 06/20/2020
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Provider Practice Location Address
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Address Line | 45400 MARKETPLACE BLVD
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City | CHESTERFIELD
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State | MI
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Zip | 48051-3279
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Country | US
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Telephone | 586-421-1265
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Fax | 586-421-1267
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Provider Business Mailing Address
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Address Line | 49668 SANDRA DR
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City | SHELBY TWP
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State | MI
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Zip | 48315-3537
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Country | US
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Telephone | 586-354-0059
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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 | 5302037696
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License Number State | MI
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