MEDICARE: IYYAD Y ABUEIDA RPH

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	5302031709	MI

General Provider Information

NPI Number	:	1528120227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IYYAD Y ABUEIDA RPH

Provider Business Mailing Address
First Line	:	4965 HEATHER DR APT 206
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48126-4175
Country	:	US
Telephone Number	:	313-443-1118
Fax Number	:	313-838-3166

Provider Business Practice Location Address
First Line	:	16311 GRAND RIVER AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48227-1825
Country	:	US
Telephone Number	:	313-838-1900
Fax Number	:	313-838-3166

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

Provider Enumeration Date	:	12/16/2006
Last Update Date	:	07/08/2007

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Directions to “ IYYAD Y ABUEIDA RPH” Practice Location

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