MEDICARE: GAZAL HARWANI PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	5302043639	MI

General Provider Information

NPI Number	:	1407221047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAZAL HARWANI PHARMD

Provider Business Mailing Address
First Line	:	32720 HARPER AVE
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48082-1034
Country	:	US
Telephone Number	:	419-215-1208
Fax Number	:

Provider Business Practice Location Address
First Line	:	25014 LITTLE MACK AVE
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48080-1118
Country	:	US
Telephone Number	:	586-359-6517
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2015
Last Update Date	:	12/08/2015

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Directions to “ GAZAL HARWANI PHARMD” Practice Location

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