Individual
MAHMOUD FARDOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7432 TERNES, DEARBORN, MI 48126
(313) 443-5598
Mailing address
6607 PAYNE AVE, DEARBORN, MI 48126-1740
(313) 443-5598
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302033182
MI
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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