Provider Demographics
NPI:1447977319
Name:HIDER, NADIA (RPH)
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:HIDER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12818 W WARREN AVE # 2
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1533
Mailing Address - Country:US
Mailing Address - Phone:313-584-7272
Mailing Address - Fax:
Practice Address - Street 1:12818 W WARREN AVE
Practice Address - Street 2:ADDRESS LINE 2
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126
Practice Address - Country:US
Practice Address - Phone:313-584-7272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302026874183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist