Abdullah Mallisho, M.D.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

4301094502 Issued in MI

Practice address

5250 Auto Club Dr
Ste 200
Dearborn, MI 48126-4212

Phone

(313) 914-5591

Fax

(313) 982-9942

NPI assigned

Sep 10, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1252540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1174856983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 AUTO CLUB DR",
            "address_2": "STE 200",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264212",
            "telephone_number": "313-914-5591",
            "fax_number": "313-982-9942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 AUTO CLUB DR",
            "address_2": "STE 200",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264212",
            "telephone_number": "313-914-5591",
            "fax_number": "313-982-9942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLISHO",
        "first_name": "ABDULLAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-10",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301094502",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301094502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jouhaina Maleh, M.D.
• Michael S. Malian, M.D.
• Suleman Malik
• Hala Mallah, LMSW-C
• Srivenkata Sanjeev Mallareddy, PT
• Sandhya Mallya, MA, LLP
• Orieyonna Lakisha Malone
• Mamdouh Abdulrazzak MD PC
• Managing Minds PLLC
• Stephanie Manard

• Endocrinology, Diabetes & Metabolism Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Endocrinology, Diabetes & Metabolism Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.