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General NPI Number Information
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NPI Number | 1245996404
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Entity Type | Individual
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Provider Name | WAFAA HAKIM
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Gender | Female
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Dates
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Enumeration Date | 11/11/2021
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Last Update Date | 11/11/2021
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Provider Practice Location Address
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Address Line | 3808 MONROE ST
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City | DEARBORN
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State | MI
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Zip | 48124-3620
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Country | US
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Telephone | 313-209-3339
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Fax | 313-586-9522
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Provider Business Mailing Address
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Address Line | 1245 HILLCREST DR
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City | DEARBORN
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State | MI
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Zip | 48124-1242
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Country | US
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Telephone | 313-960-3330
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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 | 5302038443
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License Number State | MI
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