Rusul Soby
Individual provider Active NPI Pharmacist · Dearborn HTS, MI
NPI 1124772967 · NPPES record last updated Apr 10, 2026
Key facts
- NPI
- 1124772967
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302034651 (MI)
- Practice address
- 23291 Beechcrest St
Dearborn HTS, MI 48127-2305 - Phone
- (313) 729-6262
- NPI assigned
- Feb 10, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302034651 | MI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302034651 | MI | Yes |
Addresses
Primary practice location
23291 Beechcrest St
Dearborn HTS, MI 48127-2305
Mailing address
23291 Beechcrest St
Dearborn HTS, MI 48127-2305
Phone (313) 729-6262
Other providers in Dearborn HTS, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.