Provider Demographics
NPI:1679707558
Name:AHMED, MURSALA NAJI (RPH)
Entity type:Individual
Prefix:MRS
First Name:MURSALA
Middle Name:NAJI
Last Name:AHMED
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9023 JOSEPH CAMPAU ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-3726
Mailing Address - Country:US
Mailing Address - Phone:313-871-1010
Mailing Address - Fax:313-871-1011
Practice Address - Street 1:9023 JOSEPH CAMPAU ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3726
Practice Address - Country:US
Practice Address - Phone:313-871-1010
Practice Address - Fax:313-871-1011
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302030594183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist