Active NPI
Nubar Gambourian, PHARMD
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- West Bloomfield, MI
National Provider Identifier
1043194442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 5302417819
- Practice address
- 6070 W Maple Rd
West Bloomfield, MI 48322-2212 - Phone
- (248) 865-2290
- NPI assigned
- Jul 31, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 5302417819 | MI | Primary |
Addresses
Primary practice location
6070 W Maple Rd
West Bloomfield, MI 48322-2212
Mailing address
19661 Jeanette St
Southfield, MI 48075-1733
Phone (248) 996-4787
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302417819 | MI | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodward Detroit CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753920000000",
"number": "1043194442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19661 JEANETTE ST",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480751733",
"telephone_number": "248-996-4787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6070 W MAPLE RD",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483222212",
"telephone_number": "248-865-2290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMBOURIAN",
"first_name": "NUBAR",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-07-31",
"last_updated": "2025-07-31",
"certification_date": "2025-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "MI",
"license": "5302417819",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Bloomfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.