Provider Demographics
NPI:1225514193
Name:FOUDA, AHMED (RPHD, PHD)
Entity Type:Individual
Prefix:DR
First Name:AHMED
Middle Name:
Last Name:FOUDA
Suffix:
Gender:M
Credentials:RPHD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1166 VILLA PARK DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-1313
Mailing Address - Country:US
Mailing Address - Phone:313-725-0051
Mailing Address - Fax:
Practice Address - Street 1:1705 W MOUNT HOPE AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-2660
Practice Address - Country:US
Practice Address - Phone:517-372-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302044188183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist