Provider Demographics
NPI:1932325867
Name:GRANADER, HADAR (RPH)
Entity Type:Individual
Prefix:MR
First Name:HADAR
Middle Name:
Last Name:GRANADER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1553 ISLAND LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-1312
Mailing Address - Country:US
Mailing Address - Phone:248-909-8737
Mailing Address - Fax:248-626-7264
Practice Address - Street 1:8641 N TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-1425
Practice Address - Country:US
Practice Address - Phone:313-274-5332
Practice Address - Fax:313-274-8968
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020191811835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric