Provider Demographics
NPI:1356767081
Name:BAYDOUN, ZEINAB MOHAMMAD-ALI
Entity type:Individual
Prefix:
First Name:ZEINAB
Middle Name:MOHAMMAD-ALI
Last Name:BAYDOUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6015 HUBBELL ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2498
Mailing Address - Country:US
Mailing Address - Phone:313-467-6676
Mailing Address - Fax:
Practice Address - Street 1:6015 HUBBELL ST
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-2498
Practice Address - Country:US
Practice Address - Phone:313-467-6676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-05
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302038944183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist