Provider Demographics
NPI:1780396358
Name:ABAZEED, OMAR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:OMAR
Middle Name:
Last Name:ABAZEED
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 1:20232 RIVER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2763
Mailing Address - Country:US
Mailing Address - Phone:313-525-1915
Mailing Address - Fax:
Practice Address - Street 1:20250 W 7 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-3469
Practice Address - Country:US
Practice Address - Phone:313-535-9755
Practice Address - Fax:313-535-9655
Is Sole Proprietor?:No
Enumeration Date:2022-12-15
Last Update Date:2024-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315237757183500000X
MI5302414941183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist