Provider Demographics
NPI:1740448919
Name:SHAFIE, SAAD R (RPH)
Entity type:Individual
Prefix:MR
First Name:SAAD
Middle Name:R
Last Name:SHAFIE
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 1:20201 W 7 MILE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-3406
Mailing Address - Country:US
Mailing Address - Phone:313-533-8200
Mailing Address - Fax:313-538-2223
Practice Address - Street 1:20201 W 7 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-3406
Practice Address - Country:US
Practice Address - Phone:313-533-8200
Practice Address - Fax:313-538-2223
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302022438183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302022438OtherSTATE OF MICHIGAN PHARMACY LICENSE NUMBER