Individual provider Active NPI

Mizanur Rahman Miah, PHARM.D.

  • Pharmacist
  • Warren, MI
National Provider Identifier
1831799295
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302044571 Issued in MI
Practice address
29176 Van Dyke Ave
Warren, MI 48093-6764
Phone
(586) 467-0265
Fax
(586) 467-0259
NPI assigned
Oct 27, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 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 5302044571 MI Primary

Addresses

Primary practice location

29176 Van Dyke Ave
Warren, MI 48093-6764

Mailing address

14509 Royal Dr
Sterling Heights, MI 48312-4369
Phone (313) 485-2128

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
5302044571MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1831799295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14509 ROYAL DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483124369",
            "telephone_number": "313-485-2128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29176 VAN DYKE AVE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480936764",
            "telephone_number": "586-467-0265",
            "fax_number": "586-467-0259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIAH",
        "first_name": "MIZANUR",
        "middle_name": "RAHMAN",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302044571",
            "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 Oct 27, 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.