Provider Demographics
NPI:1326700584
Name:HASSAN, MALEK (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MALEK
Middle Name:
Last Name:HASSAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2649 ROULO ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48120-1542
Mailing Address - Country:US
Mailing Address - Phone:313-502-1394
Mailing Address - Fax:
Practice Address - Street 1:27435 FORD RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2920
Practice Address - Country:US
Practice Address - Phone:734-513-2299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302413829183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist