Provider Demographics
NPI:1598177610
Name:MUSHEINESH, AHMAD (PHARMD)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:
Last Name:MUSHEINESH
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 1:15901 FORD RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2800
Mailing Address - Country:US
Mailing Address - Phone:313-768-0293
Mailing Address - Fax:
Practice Address - Street 1:15901 FORD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2800
Practice Address - Country:US
Practice Address - Phone:313-768-0293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302039760183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist