Provider Demographics
NPI:1275170052
Name:GHELANI, NUPUR M
Entity Type:Individual
Prefix:
First Name:NUPUR
Middle Name:M
Last Name:GHELANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7350 N MIDDLEBELT RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-2502
Mailing Address - Country:US
Mailing Address - Phone:734-793-1050
Mailing Address - Fax:
Practice Address - Street 1:7350 N MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-2502
Practice Address - Country:US
Practice Address - Phone:734-793-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-29
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist