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General NPI Number Information
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NPI Number | 1720219868
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Entity Type | Individual
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Provider Name | COSMOS NELO GEORGE II PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 1900 E 8 MILE RD
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City | DETROIT
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State | MI
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Zip | 48234-1008
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Country | US
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Telephone | 313-892-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 23628 LONDON CT # 1512
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3314
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Country | US
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Telephone | 313-549-3500
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 5302032227
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License Number State | MI
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