Provider Demographics
NPI:1629203856
Name:JOSEPH, SHAIJA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHAIJA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2249 N CANTON CENTER RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2954
Mailing Address - Country:US
Mailing Address - Phone:734-844-3598
Mailing Address - Fax:734-844-1535
Practice Address - Street 1:2249 N CANTON CENTER RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2954
Practice Address - Country:US
Practice Address - Phone:734-844-3598
Practice Address - Fax:734-844-1535
Is Sole Proprietor?:No
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302035127183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist