Mubarak Algazzaly, PHARMD
Individual provider Active NPI Pharmacist · Canton, MI
NPI 1144825571 · NPPES record last updated Dec 28, 2020
Key facts
- NPI
- 1144825571
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302413119 (MI)
- Practice address
- 42433 Ford Rd
Canton, MI 48187-3303 - Phone
- (734) 981-3900
- NPI assigned
- Dec 3, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302413119 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodward Detroit CVS, L.L.C. | Past |
Accepting new patients | |
| Woodward Detroit CVS, L.L.C. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302413119 | MI | Yes |
Addresses
Primary practice location
42433 Ford Rd
Canton, MI 48187-3303
Mailing address
5408 Whittaker Rd
Ypsilanti, MI 48197-9751
Phone (734) 481-3381
Other providers in Canton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2020. 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.