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NPI Code Detail

MEDICARE: MS. DALJIT VIRDI RPH

MEDICARE: MS. DALJIT VIRDI 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
1183500000XPharmacist5302031389MI

General Provider Information

NPI Number : 1760766877
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DALJIT VIRDI RPH
Provider Business Mailing Address
First Line : 48246 ROSEWOOD DR
Second Line :
City : SHELBY TOWNSHIP
State : MI
Zip : 48315-4069
Country : US
Telephone Number : 586-997-6903
Fax Number :
Provider Business Practice Location Address
First Line : 32201 HARPER AVE
Second Line :
City : SAINT CLAIR SHORES
State : MI
Zip : 48082-1408
Country : US
Telephone Number : 586-293-5152
Fax Number : 586-293-7839
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2011
Last Update Date : 10/07/2011

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