Fatima Abbas
Individual provider Active NPI Pharmacist · Detroit, MI
NPI 1811513237 · NPPES record last updated May 29, 2025
Key facts
- NPI
- 1811513237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5315110358 (MI)
- Practice address
- 4646 John R St
Detroit, MI 48201-1916 - Phone
- (313) 576-1000
- NPI assigned
- Jun 22, 2020
- Sex
- Female
- Sole proprietor
- No
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5315110358 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5315110358 | MI | Yes |
Addresses
Primary practice location
4646 John R St
Detroit, MI 48201-1916
Mailing address
4646 John R St
Detroit, MI 48201-1916
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2025. 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.