Provider Demographics
NPI:1073272381
Name:RAYES, AHMAD (RPH)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:
Last Name:RAYES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6629 APPOLINE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1961
Mailing Address - Country:US
Mailing Address - Phone:313-467-3903
Mailing Address - Fax:
Practice Address - Street 1:18340 ALLEN RD
Practice Address - Street 2:
Practice Address - City:MELVINDALE
Practice Address - State:MI
Practice Address - Zip Code:48122-1560
Practice Address - Country:US
Practice Address - Phone:313-928-2559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302413771183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist