Active NPI
Mais Badwan, PHARM.D.
- Pharmacist
- Detroit, MI
National Provider Identifier
1063756740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051288519
- Practice address
- 4201 Saint Antoine St
Detroit, MI 48201-2153 - Phone
- (313) 745-3518
- Fax
- (313) 993-0525
- NPI assigned
- Nov 19, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302040155 | MI | |
| Pharmacist | 183500000X | 051288519 | IL | Primary |
Addresses
Primary practice location
4201 Saint Antoine St
Detroit, MI 48201-2153
Mailing address
4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (313) 745-3518
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051288519 | IL | MD | Pharmacist |
| 5302040155 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353283200000",
"number": "1063756740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 SAINT ANTOINE ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012153",
"telephone_number": "313-745-3518",
"fax_number": "313-993-0525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 SAINT ANTOINE ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012153",
"telephone_number": "313-745-3518",
"fax_number": "313-993-0525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BADWAN",
"first_name": "MAIS",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-19",
"last_updated": "2012-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302040155",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051288519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.