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General NPI Number Information
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NPI Number | 1992585798
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Entity Type | Individual
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Provider Name | ZIAD Z JIDDOU PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/29/2023
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 31320 FIVE MILE RD
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City | LIVONIA
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State | MI
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Zip | 48154-3644
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Country | US
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Telephone | 734-427-3430
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Fax |
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Provider Business Mailing Address
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Address Line | 38746 TRISTRAM DR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-1779
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Country | US
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Telephone | 586-244-9518
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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 | 5302415398
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License Number State | MI
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