Provider Demographics
NPI:1174179642
Name:SAAD, HASSEN
Entity Type:Individual
Prefix:
First Name:HASSEN
Middle Name:
Last Name:SAAD
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 1:26737 TIMBER TRL
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-3375
Mailing Address - Country:US
Mailing Address - Phone:313-806-8966
Mailing Address - Fax:
Practice Address - Street 1:15014 E 8 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48205-1352
Practice Address - Country:US
Practice Address - Phone:313-598-3031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032616183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist