Provider Demographics
NPI:1740915164
Name:DABAJA, ALI JIHAD
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:JIHAD
Last Name:DABAJA
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 1:31411 CHERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-5264
Mailing Address - Country:US
Mailing Address - Phone:734-326-2990
Mailing Address - Fax:
Practice Address - Street 1:31411 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-5264
Practice Address - Country:US
Practice Address - Phone:734-326-2990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302414191183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist