Provider Demographics
NPI:1417380353
Name:CHEHAB, ALI HASSAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:HASSAN
Last Name:CHEHAB
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 1:5801 CALHOUN ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2237
Mailing Address - Country:US
Mailing Address - Phone:313-415-6078
Mailing Address - Fax:
Practice Address - Street 1:3270 GREENFIELD RD STE 101
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-1161
Practice Address - Country:US
Practice Address - Phone:248-284-6969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302040613183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist