BASIL M FATHALLA (NPI# 1205879954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205879954 |
| Entity Type | Individual |
| Full Name | BASIL M FATHALLA |
| Credential | M.D. |
| Practice Address |
3901 Beaubien St Children's Hospital of Mi Detroit MI 48201-2119 |
| Mailing Address |
4201 St. Antoine University Pediatricians Uhc 6f Mailbox# 226 Detroit MI 48201-4139 |
| Practice Telephone | 2154275094 |
| Mailing Telephone | 3139665051 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2009-05-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0216X |
Pediatrics Specialization: Pediatric Rheumatology |
MD427787 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1014672880001 | 05 |
| Street Address |
3901 BEAUBIEN ST CHILDREN'S HOSPITAL OF MI |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538151238 | Mark Campbell | Nurse Anesthetist, Certified Registered | 3901 Beaubien St, Detroit, MI 48201-2119 | 2005-08-18 |
| 1164037735 | Mamdouh Dakhel A Alahmadi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-09-10 |
| 1801407119 | Samantha Mulkiten | Nurse Practitioner | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-08-11 |
| 1346864550 | Mariane Tomiyoshi Asato | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-06-03 |
| 1629691613 | Abigail Marie Troy | Pediatrics | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-05-25 |
| 1235750373 | Katherine Marie Obudzinski | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-04-29 |
| 1548880073 | Sara Mercedes Evans | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-24 |
| 1619597069 | Zahur Fatima Sallman | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-24 |
| 1154941706 | Saira Tariq | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-23 |
| 1063032688 | Michael Allen Finkel | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
| Find all providers in zip 48201 | ||||
| Taxonomy Code | 2080P0216X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Rheumatology |
| A pediatrician who treats diseases of joints, muscle, bones and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033524335 | Regents of The University of Michigan | Pediatrics | 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48105 | 2014-06-25 |
| 1306251699 | Regents of The University of Michigan | Pediatrics | 8001 Challis Road, Brighton, MI 48116 | 2014-06-25 |
| 1649492802 | Elizabeth Anne Kessler | Pediatrics | 35 Michigan St Ne, Suite 4150, Grand Rapids, MI 49503-2514 | 2007-05-03 |
| 1275502445 | Mary D Moore | Pediatrics | 1000 Oakland Dr, Kalamazoo, MI 49008-1282 | 2006-03-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.