Provider Demographics
NPI:1942714696
Name:DIRANI, MOHAMAD (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:MOHAMAD
Middle Name:
Last Name:DIRANI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8275 N WAYNE RD STE B
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-1143
Mailing Address - Country:US
Mailing Address - Phone:313-505-8242
Mailing Address - Fax:
Practice Address - Street 1:8275 N WAYNE RD STE B
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-1143
Practice Address - Country:US
Practice Address - Phone:313-505-8242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302042159183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist