Provider Demographics
NPI:1083215636
Name:SEYEDIN, SAHAR (PHARMD)
Entity Type:Individual
Prefix:
First Name:SAHAR
Middle Name:
Last Name:SEYEDIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6065 GULL RD
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-9433
Mailing Address - Country:US
Mailing Address - Phone:269-373-1367
Mailing Address - Fax:269-373-1372
Practice Address - Street 1:6065 GULL RD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-9433
Practice Address - Country:US
Practice Address - Phone:269-373-1367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302040287183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist