Active NPI
Mahmoud A-M Farea
- Pharmacist
- Saint Clair Shores, MI
National Provider Identifier
1215682836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302412421
- Practice address
- 21211 Harper Ave
Saint Clair Shores, MI 48080-2208 - Phone
- (586) 776-7052
- Fax
- (586) 776-7148
- NPI assigned
- Feb 14, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302412421 | MI | Primary |
Addresses
Primary practice location
21211 Harper Ave
Saint Clair Shores, MI 48080-2208
Mailing address
PO Box 7184
Dearborn, MI 48121-7184
Phone (202) 600-6681
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302412421 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644796800000",
"number": "1215682836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7184",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481217184",
"telephone_number": "202-600-6681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21211 HARPER AVE",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "480802208",
"telephone_number": "586-776-7052",
"fax_number": "586-776-7148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAREA",
"first_name": "MAHMOUD",
"middle_name": "A-M",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-02-14",
"last_updated": "2022-02-14",
"certification_date": "2022-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302412421",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Clair Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.