Provider Demographics
NPI:1265030464
Name:ELSHEICK, NOUR (PHARMD)
Entity Type:Individual
Prefix:
First Name:NOUR
Middle Name:
Last Name:ELSHEICK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:NOUR
Other - Middle Name:
Other - Last Name:ABADEH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:6201 NIGHTINGALE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-3054
Mailing Address - Country:US
Mailing Address - Phone:313-408-3453
Mailing Address - Fax:
Practice Address - Street 1:41460 HAGGERTY CIR S
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-2227
Practice Address - Country:US
Practice Address - Phone:888-282-5166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302045297183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist