Tanveer Fatima
Individual provider Active NPI Pharmacist · Ortonville, MI
NPI 1366001075 · NPPES record last updated Jun 7, 2019
Key facts
- NPI
- 1366001075
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302040425 (MI)
- Practice address
- 10 S Ortonville Rd
Ortonville, MI 48462-8818 - Phone
- (248) 627-2888
- NPI assigned
- Jun 7, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
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 |
|---|---|---|---|
| 5302040425 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rite Aid of Michigan Inc | Past | Accepting new patients | |
| Rite Aid of Michigan Inc | Past | Accepting new patients | |
| Rite Aid | Pharmacist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302040425 | MI | Yes |
Addresses
Primary practice location
10 S Ortonville Rd
Ortonville, MI 48462-8818
Mailing address
27408 Strawberry LN Apt 102
Farmington Hills, MI 48334-5064
Phone (248) 880-2989
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5302040425 | Other | MI | PHARMACIST LICENSE NUMBER |
Other providers in Ortonville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2019. 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.