Provider Demographics
NPI:1528387925
Name:SHAMASS, SELMA P (PHARMACIST BS)
Entity Type:Individual
Prefix:
First Name:SELMA
Middle Name:P
Last Name:SHAMASS
Suffix:
Gender:F
Credentials:PHARMACIST BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36485 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-1132
Mailing Address - Country:US
Mailing Address - Phone:586-791-0738
Mailing Address - Fax:
Practice Address - Street 1:36485 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48035-1132
Practice Address - Country:US
Practice Address - Phone:586-791-0738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302034358183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist