Provider Demographics
NPI:1114517190
Name:MUHSEN, ADNAN HASSAN
Entity Type:Individual
Prefix:
First Name:ADNAN
Middle Name:HASSAN
Last Name:MUHSEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 W TAMI CIR APT C201
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-9097
Mailing Address - Country:US
Mailing Address - Phone:313-268-7675
Mailing Address - Fax:
Practice Address - Street 1:4433 MILLER RD STE 102
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1123
Practice Address - Country:US
Practice Address - Phone:810-733-6653
Practice Address - Fax:810-733-8789
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302046422183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist