Provider Demographics
NPI:1689205643
Name:KADADO, HIBA AHMAD (DR)
Entity Type:Individual
Prefix:
First Name:HIBA
Middle Name:AHMAD
Last Name:KADADO
Suffix:
Gender:F
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22492 CHESTER CT APT 2201
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-3908
Mailing Address - Country:US
Mailing Address - Phone:281-414-9506
Mailing Address - Fax:
Practice Address - Street 1:42433 FORD RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3303
Practice Address - Country:US
Practice Address - Phone:734-981-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315136966183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist