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NPI Code Detail

MEDICARE: MAHMOUD SROUR

MEDICARE: MAHMOUD SROUR
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
1183500000XPharmacist5302041136MI

General Provider Information

NPI Number : 1528579331
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAHMOUD SROUR
Provider Business Mailing Address
First Line : 5940 MIDDLESEX ST
Second Line :
City : DEARBORN
State : MI
Zip : 48126-2166
Country : US
Telephone Number : 313-445-5656
Fax Number :
Provider Business Practice Location Address
First Line : 4100 WOODWARD AVE STE PHARMACY
Second Line :
City : DETROIT
State : MI
Zip : 48201-2173
Country : US
Telephone Number : 313-832-5900
Fax Number : 313-832-5901
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2017
Last Update Date : 10/19/2017

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Directions to “ MAHMOUD SROUR ” Practice Location

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