Kamal Fahim, M.D., P.L.C.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

4301090236 Issued in MI

Legal business name

KAMAL FAHIM, M.D., P.L.C.

Practice address

4190 24TH Ave Ste 204
Fort Gratiot, MI 48059-3884

Phone

(810) 989-7702

Fax

(810) 989-7703

NPI assigned

Jul 15, 2011

Organization subpart

No

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

Authorized official

Name

Kamal Fahim, M.D.NPI 1417150681

Title

Sole Member

Phone

(810) 989-7702

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kamal Fahim, MD

  • Ophthalmology Physician
  • Detroit, MI
  • NPI 1417150681
  Medicare reassignment Care Compare group NPD Authorized official
• Carson Day, OD

  • Optometrist
  • Fort Gratiot, MI
  • NPI 1285204339
  Medicare reassignment Care Compare group NPD
• Lindsay Marie Labelle, O.D.

  • Optometrist
  • Fort Gratiot, MI
  • NPI 1184008252
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310688000000",
    "number": "1265720932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 24TH AVE STE 204",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593884",
            "telephone_number": "810-989-7702",
            "fax_number": "810-989-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 24TH AVE STE 204",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593884",
            "telephone_number": "810-989-7702",
            "fax_number": "810-989-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAMAL FAHIM, M.D., P.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-15",
        "last_updated": "2011-07-15",
        "status": "A",
        "authorized_official_last_name": "FAHIM",
        "authorized_official_first_name": "KAMAL",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "810-989-7702",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301090236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Jones
• Jordan Bennett LMSW
• Jennifer Lynn Jurzysta
• Tabitha L Kaboni
• Holly Frances Kallek, PHARM.D.
• Abbey Lynn Kamendat
• Josephine M Kamendat, FNP -C
• Kayla Rose Kamendat
• Paige Marie Kamendat
• Sandra Sue Kammer, MSW

• Ophthalmology Physician in Fort Gratiot, MI
• Providers in Fort Gratiot, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.