Provider Demographics
NPI:1982616405
Name:JAWARD, NAZIH
Entity Type:Individual
Prefix:MR
First Name:NAZIH
Middle Name:
Last Name:JAWARD
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 1:15635 W WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-3733
Mailing Address - Country:US
Mailing Address - Phone:313-584-3377
Mailing Address - Fax:
Practice Address - Street 1:15635 W WARREN AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-3733
Practice Address - Country:US
Practice Address - Phone:313-584-3377
Practice Address - Fax:313-584-8336
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302410828183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist