Provider Demographics
NPI:1740455708
Name:DANDAN, NADA N (PHARM D)
Entity type:Individual
Prefix:DR
First Name:NADA
Middle Name:N
Last Name:DANDAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1549 HOLMES RD
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-4147
Mailing Address - Country:US
Mailing Address - Phone:734-547-9100
Mailing Address - Fax:734-547-9144
Practice Address - Street 1:1549 HOLMES RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-4147
Practice Address - Country:US
Practice Address - Phone:734-547-9100
Practice Address - Fax:734-547-9144
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302027239183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist