MEDICARE: ALI ANBAKI

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	5302045492	MI

General Provider Information

NPI Number	:	1407313588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALI ANBAKI

Provider Business Mailing Address
First Line	:	5451 BENTLEY RD APT 105
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-2175
Country	:	US
Telephone Number	:	215-906-6564
Fax Number	:

Provider Business Practice Location Address
First Line	:	4019 METRO PKWY
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-4517
Country	:	US
Telephone Number	:	586-446-8104
Fax Number	:

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

Provider Enumeration Date	:	02/26/2019
Last Update Date	:	02/26/2019

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Directions to “ ALI ANBAKI ” Practice Location

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