Provider Demographics
NPI:1013429364
Name:ALI, SYED AMJAD (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:SYED
Middle Name:AMJAD
Last Name:ALI
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 1:2010 N SAINT HELEN RD
Mailing Address - Street 2:
Mailing Address - City:SAINT HELEN
Mailing Address - State:MI
Mailing Address - Zip Code:48656-8555
Mailing Address - Country:US
Mailing Address - Phone:989-389-4965
Mailing Address - Fax:
Practice Address - Street 1:2010 N SAINT HELEN RD
Practice Address - Street 2:
Practice Address - City:SAINT HELEN
Practice Address - State:MI
Practice Address - Zip Code:48656-8555
Practice Address - Country:US
Practice Address - Phone:989-389-4965
Practice Address - Fax:989-389-4965
Is Sole Proprietor?:No
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302034962183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist