Provider Demographics
NPI:1205427796
Name:FARHAT, MOUHAMAD (PHARMD)
Entity type:Individual
Prefix:
First Name:MOUHAMAD
Middle Name:
Last Name:FARHAT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20845 FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2683
Mailing Address - Country:US
Mailing Address - Phone:313-789-7665
Mailing Address - Fax:
Practice Address - Street 1:20845 FAIRVIEW DR
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-2683
Practice Address - Country:US
Practice Address - Phone:313-789-7665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302412258183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist