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NPI 1487065249

NPI 1487065249 : MOHAMAD HAMADE : WAYNE, MI

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General NPI Number Information
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    NPI Number           |    1487065249
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    Entity Type          |    Individual 
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    Provider Name        |    MOHAMAD HAMADE
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/15/2014
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    Last Update Date     |    02/03/2020
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Provider Practice Location Address
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    Address Line         |    31450 VAN BORN RD 
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    City                 |    WAYNE
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    State                |    MI
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    Zip                  |    48184-2631
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    Country              |    US
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    Telephone            |    734-728-4295
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    Fax                  |    734-728-4375
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Provider Business Mailing Address
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    Address Line         |    31450 VAN BORN RD 
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    City                 |    WAYNE
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    State                |    MI
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    Zip                  |    48184-2698
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    Country              |    US
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    Telephone            |    734-728-4295
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    Fax                  |    734-728-4375
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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       |    5302035451
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    License Number State |    MI
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Taxonomy #2
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    S015549
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    License Number State |    AZ
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