Provider Demographics
NPI:1073283446
Name:RAYES, OUSSAMA (PHARMD)
Entity Type:Individual
Prefix:
First Name:OUSSAMA
Middle Name:
Last Name:RAYES
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 1:5445 JONATHON ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-3315
Mailing Address - Country:US
Mailing Address - Phone:313-442-2333
Mailing Address - Fax:
Practice Address - Street 1:5445 JONATHON ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-3315
Practice Address - Country:US
Practice Address - Phone:313-442-2333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302413797183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist