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General NPI Number Information
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NPI Number | 1720724750
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Entity Type | Individual
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Provider Name | NOOR NAKKASH
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Gender | Male
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Dates
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Enumeration Date | 05/11/2022
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 24371 CATHERINE INDUSTRIAL DR STE 201
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City | NOVI
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State | MI
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Zip | 48375-2422
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Country | US
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Telephone | 248-252-4994
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Fax |
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Provider Business Mailing Address
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Address Line | 28945 NOTTOWAY DR
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City | FARMINGTON HILLS
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State | MI
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Zip | 48331-2581
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Country | US
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Telephone | 248-252-4994
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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 | 5302042113
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License Number State | MI
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