Provider Demographics
NPI:1487028726
Name:AHMAD, ALI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:AHMAD
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 1:6868 REUTER ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1833
Mailing Address - Country:US
Mailing Address - Phone:313-377-6696
Mailing Address - Fax:
Practice Address - Street 1:5851 MERCURY DR
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-4161
Practice Address - Country:US
Practice Address - Phone:313-441-2841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302042033183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist