Provider Demographics
NPI:1275838567
Name:AL-SUBARI, NABIL M
Entity Type:Individual
Prefix:MR
First Name:NABIL
Middle Name:M
Last Name:AL-SUBARI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 ROULO ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48120
Mailing Address - Country:US
Mailing Address - Phone:313-663-0424
Mailing Address - Fax:
Practice Address - Street 1:9811 CONANT ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3877
Practice Address - Country:US
Practice Address - Phone:313-871-1115
Practice Address - Fax:313-871-1231
Is Sole Proprietor?:No
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302039729183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist