Provider Demographics
NPI:1437265519
Name:JARWARD, MAHMOUD AHMAD (RPH)
Entity Type:Individual
Prefix:MR
First Name:MAHMOUD
Middle Name:AHMAD
Last Name:JARWARD
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 1:13433 W 8 MILE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-1043
Mailing Address - Country:US
Mailing Address - Phone:313-341-8948
Mailing Address - Fax:313-341-9108
Practice Address - Street 1:13433 W 8 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-1043
Practice Address - Country:US
Practice Address - Phone:313-341-8948
Practice Address - Fax:313-341-9108
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302031036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist