Provider Demographics
NPI:1932795069
Name:ABDULGHANI, ZAID ZAKI GORGEES
Entity Type:Individual
Prefix:
First Name:ZAID ZAKI GORGEES
Middle Name:
Last Name:ABDULGHANI
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 1:1537 MERRIWEATHER DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-6802
Mailing Address - Country:US
Mailing Address - Phone:915-841-8562
Mailing Address - Fax:
Practice Address - Street 1:1621 E M 21
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-9053
Practice Address - Country:US
Practice Address - Phone:989-723-2656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-13
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302412786183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty