Wijdan Ali Alyasiry
Individual provider Active NPI Pharmacist · Oak Park, MI
NPI 1457063513 · NPPES record last updated Dec 20, 2022
Key facts
- NPI
- 1457063513
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302414731 (MI)
- Practice address
- 13550 W 9 Mile Rd
Oak Park, MI 48237-2852 - Phone
- (248) 548-4251
- NPI assigned
- Dec 20, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| 5302414731 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302414731 | MI | Yes |
Addresses
Primary practice location
13550 W 9 Mile Rd
Oak Park, MI 48237-2852
Mailing address
13550 W 9 Mile Rd
Oak Park, MI 48237-2852
Phone (248) 548-4251
Other providers in Oak Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2022. 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.