Provider Demographics
NPI:1942259759
Name:SHAHBAIN, MOJEEB (RPH)
Entity Type:Individual
Prefix:MR
First Name:MOJEEB
Middle Name:
Last Name:SHAHBAIN
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 1:14155 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-5422
Mailing Address - Country:US
Mailing Address - Phone:734-744-4844
Mailing Address - Fax:734-744-4847
Practice Address - Street 1:14155 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-5422
Practice Address - Country:US
Practice Address - Phone:734-744-4844
Practice Address - Fax:734-744-4847
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302035512183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist