Provider Demographics
NPI:1619610193
Name:SLAIWA, ORAL ADIL
Entity Type:Individual
Prefix:
First Name:ORAL
Middle Name:ADIL
Last Name:SLAIWA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ORAL
Other - Middle Name:ADIL
Other - Last Name:SLEWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:39834 BAKER DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-1903
Mailing Address - Country:US
Mailing Address - Phone:586-275-8937
Mailing Address - Fax:
Practice Address - Street 1:600 W 9 MILE RD
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-2969
Practice Address - Country:US
Practice Address - Phone:248-761-0985
Practice Address - Fax:248-761-0965
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302414223183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist