Provider Demographics
NPI:1346380342
Name:SALEH, EMAD (RPH)
Entity Type:Individual
Prefix:
First Name:EMAD
Middle Name:
Last Name:SALEH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8040 W VERNOR HWY
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48209-1522
Mailing Address - Country:US
Mailing Address - Phone:313-297-3550
Mailing Address - Fax:313-297-3552
Practice Address - Street 1:8040 W VERNOR HWY
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48209-1522
Practice Address - Country:US
Practice Address - Phone:313-297-3550
Practice Address - Fax:313-297-3552
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302031679183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2365838Medicaid
MI5167780001OtherMEDICARE PART B NSC#
MI5167780001Medicare NSC
MI5167780001OtherMEDICARE PART B NSC#