Provider Demographics
NPI:1558896977
Name:SYED, MUNAWAR
Entity Type:Individual
Prefix:
First Name:MUNAWAR
Middle Name:
Last Name:SYED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7147 GRANADA DR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3025
Mailing Address - Country:US
Mailing Address - Phone:203-707-6638
Mailing Address - Fax:
Practice Address - Street 1:301 E GENESEE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48607-1242
Practice Address - Country:US
Practice Address - Phone:989-755-7998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-23
Last Update Date:2017-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302039836183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist