Provider Demographics
NPI:1154705580
Name:HAMAD, ALI (PHARMD)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:HAMAD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6225 PENROD ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-3871
Mailing Address - Country:US
Mailing Address - Phone:313-443-4787
Mailing Address - Fax:
Practice Address - Street 1:120 INKSTER RD
Practice Address - Street 2:
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-1209
Practice Address - Country:US
Practice Address - Phone:313-724-8382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302041790183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist