Individual
ALI FARDOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
7555 TELEGRAPH RD, TAYLOR, MI 48180-2239
(313) 292-5014
Mailing address
22822 WILSON AVE, DEARBORN, MI 48128-1851
(313) 523-6011
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302033826
MI
Other
Enumeration date
04/27/2019
Last updated
04/27/2019
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