Individual provider Active NPI

Dylon Daoud

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1215622899
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5151016096 Issued in MI
Practice address
22250 Providence Dr
Southfield, MI 48075-4825
Phone
(248) 849-3281
Fax
(248) 849-5449
NPI assigned
Apr 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 5151016096 MI Primary

Addresses

Primary practice location

22250 Providence Dr
Southfield, MI 48075-4825

Mailing address

22250 Providence Dr
Southfield, MI 48075-4825
Phone (248) 849-3281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230706001027 MI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5395104558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5151016096MIMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1215622899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754825",
            "telephone_number": "248-849-3281",
            "fax_number": "248-849-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754825",
            "telephone_number": "248-849-3281",
            "fax_number": "248-849-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAOUD",
        "first_name": "DYLON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5151016096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.