Individual
ALI MOUKDAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4234 MAPLE, DEARBORN, MI 48126-3544
(313) 971-6360
Mailing address
4234 MAPLE ST, DEARBORN, MI 48126-3544
(313) 971-6360
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302040053
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302040053
MICHIGAN PHARMACIST LICENSE
MI
Enumeration date
10/15/2012
Last updated
10/15/2012
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