Active NPI
Azzam F Moussawel, PHARM.D.
- Pharmacist
- Madison Heights, MI
National Provider Identifier
1265749840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302037263
- Practice address
- 25355 Dequindre Rd
Madison Heights, MI 48071-4241 - Phone
- (248) 399-4002
- NPI assigned
- Sep 2, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 | 5302037263 | MI | Primary |
Addresses
Primary practice location
25355 Dequindre Rd
Madison Heights, MI 48071-4241
Mailing address
18455 Manor LN
Livonia, MI 48152-3902
Phone (734) 718-3705
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 |
|---|---|---|---|
| 5302037263 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Vita LLC | Current | Accepting new patients | |
| Riteaid | 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.
-
- Community/Retail Pharmacy
- Dearborn, MI
- NPI 1053836874
-
- Pharmacy
- Madison Heights, MI
- NPI 1902219454
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283385600000",
"number": "1265749840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18455 MANOR LN",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481523902",
"telephone_number": "734-718-3705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25355 DEQUINDRE RD",
"city": "MADISON HEIGHTS",
"state": "MI",
"postal_code": "480714241",
"telephone_number": "248-399-4002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUSSAWEL",
"first_name": "AZZAM",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-02",
"last_updated": "2010-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302037263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.