Individual provider Active NPI

Maya Mohiddin

  • Pharmacist
  • Warren, MI
National Provider Identifier
1770115784
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302411859 Issued in MI
Practice address
28800 Dequindre Rd
Warren, MI 48092-2466
Phone
(586) 353-1151
NPI assigned
Feb 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302411859 MI Primary

Addresses

Primary practice location

28800 Dequindre Rd
Warren, MI 48092-2466

Mailing address

42215 Parkside Cir Apt 105
Sterling Heights, MI 48314-3349
Phone (989) 941-9318

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

State licenses

LicenseStateTypeSpecialty
5302411859MIMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1770115784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42215 PARKSIDE CIR APT 105",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483143349",
            "telephone_number": "989-941-9318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28800 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922466",
            "telephone_number": "586-353-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHIDDIN",
        "first_name": "MAYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302411859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.