Provider Demographics
NPI:1023239381
Name:HASSAN, AHMED A (RPH, CGP)
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:A
Last Name:HASSAN
Suffix:
Gender:M
Credentials:RPH, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 HORSESHOE CIR
Mailing Address - Street 2:APT # 205
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-2823
Mailing Address - Country:US
Mailing Address - Phone:630-242-1705
Mailing Address - Fax:
Practice Address - Street 1:1226 HORSESHOE CIR
Practice Address - Street 2:APT # 205
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-2823
Practice Address - Country:US
Practice Address - Phone:630-242-1705
Practice Address - Fax:630-242-1705
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020361631835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric