Provider Demographics
NPI:1770478182
Name:FAIYAZ, TAMKEEN
Entity type:Individual
Prefix:
First Name:TAMKEEN
Middle Name:
Last Name:FAIYAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10475 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-5704
Mailing Address - Country:US
Mailing Address - Phone:734-427-0422
Mailing Address - Fax:734-427-0424
Practice Address - Street 1:10475 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-5704
Practice Address - Country:US
Practice Address - Phone:734-427-0422
Practice Address - Fax:734-427-0424
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302411979183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist