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General NPI Number Information
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NPI Number | 1578057683
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Entity Type | Individual
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Provider Name | SAMEERAH S CORTEZ
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Gender | Female
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 11650 BELLEVILLE RD STE 103
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City | VAN BUREN TWP
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State | MI
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Zip | 48111-3382
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Country | US
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Telephone | 734-325-6318
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Fax |
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Provider Business Mailing Address
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Address Line | 11650 BELLEVILLE RD STE 103
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City | VAN BUREN TWP
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State | MI
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Zip | 48111-3382
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Country | US
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Telephone | 734-325-6318
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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 | 5302030035
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License Number State | MI
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