Provider Demographics
NPI:1609177849
Name:FAKIH, NABIL H (RPH)
Entity Type:Individual
Prefix:
First Name:NABIL
Middle Name:H
Last Name:FAKIH
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 1:25524 FORD RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-3022
Mailing Address - Country:US
Mailing Address - Phone:313-999-0445
Mailing Address - Fax:313-724-1152
Practice Address - Street 1:25524 FORD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-3022
Practice Address - Country:US
Practice Address - Phone:313-999-0445
Practice Address - Fax:313-724-1152
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032051183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist