Provider Demographics
NPI:1306312491
Name:AL-ASSADI, AMEER (PHARMD)
Entity type:Individual
Prefix:
First Name:AMEER
Middle Name:
Last Name:AL-ASSADI
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 1:9509 REVERE DR
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48111-1677
Mailing Address - Country:US
Mailing Address - Phone:734-644-3789
Mailing Address - Fax:
Practice Address - Street 1:9509 REVERE DR
Practice Address - Street 2:
Practice Address - City:VAN BUREN TWP
Practice Address - State:MI
Practice Address - Zip Code:48111-1677
Practice Address - Country:US
Practice Address - Phone:734-644-3789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-16
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018018032183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2018018032OtherMISSOURI BOARD OF PHARMACY