Provider Demographics
NPI:1477566370
Name:HADDAD, FAHD (RPH)
Entity Type:Individual
Prefix:MR
First Name:FAHD
Middle Name:
Last Name:HADDAD
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 1:2327 OAK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-5327
Mailing Address - Country:US
Mailing Address - Phone:248-224-3767
Mailing Address - Fax:248-642-6094
Practice Address - Street 1:30100 TELEGRAPH RD
Practice Address - Street 2:SUITE 200
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4514
Practice Address - Country:US
Practice Address - Phone:248-723-0258
Practice Address - Fax:248-642-6094
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302025389183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist