Provider Demographics
NPI:1821778481
Name:WAHEEDI, FATIMA (PHARMD)
Entity Type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:WAHEEDI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 S MILL ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1825
Mailing Address - Country:US
Mailing Address - Phone:734-353-8233
Mailing Address - Fax:
Practice Address - Street 1:126 S MILL ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1825
Practice Address - Country:US
Practice Address - Phone:734-353-8233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302413532183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist