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General NPI Number Information
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NPI Number | 1285264507
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Entity Type | Individual
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Provider Name | DR. CHARBEL RONY KORAB
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Gender | Male
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Dates
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Enumeration Date | 01/26/2020
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Last Update Date | 01/26/2020
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Provider Practice Location Address
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Address Line | 2950 S NEWBURGH RD
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City | WAYNE
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State | MI
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Zip | 48184-1002
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Country | US
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Telephone | 734-728-6500
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Fax | 734-729-0969
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Provider Business Mailing Address
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Address Line | 2950 S NEWBURGH RD
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City | WAYNE
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State | MI
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Zip | 48184-1002
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Country | US
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Telephone | 734-728-6500
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Fax | 734-729-0969
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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 | 5302035422
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License Number State | MI
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