Active NPI
Mazen Hamameh DO PC
- Pediatric Adolescent Medicine Physician
- Dearborn Heights, MI
National Provider Identifier
1275825770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 5101016795
- Legal business name
- MAZEN HAMAMEH DO PC
- Practice address
- 5831 Whitefield
Dearborn Heights, MI 48127 - Phone
- (734) 839-6610
- Fax
- (734) 839-6611
- NPI assigned
- May 3, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Mazen N Hamameh, DO
- Title
- Medical Provider
- Phone
- (734) 839-6610
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 5101016795 | MI | Primary |
Addresses
Primary practice location
5831 Whitefield
Dearborn Heights, MI 48127
Mailing address
5831 Whitefield
Dearborn Heights, MI 48127
Phone (734) 839-6610
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215142153 | Other | MI | BLUE CARE NETWORK |
| 1215142153 | Medicaid | MI | |
| 1215142153 | Other | MI | COMMERICAL |
| 1215142153 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
National Provider Directory
National Provider Directory- Tax ID family
- Premier Pediatrics
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pediatrics Physician
- Dearborn Heights, MI
- NPI 1174970396
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304380800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1304380800000",
"number": "1275825770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5831 WHITEFIELD",
"city": "DEARBORN HEIGHTS",
"state": "MI",
"postal_code": "48127",
"telephone_number": "734-839-6610",
"fax_number": "734-839-6611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5831 WHITEFIELD",
"city": "DEARBORN HEIGHTS",
"state": "MI",
"postal_code": "48127",
"telephone_number": "734-839-6610",
"fax_number": "734-839-6611"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAZEN HAMAMEH DO PC",
"organizational_subpart": "NO",
"enumeration_date": "2011-05-03",
"last_updated": "2011-05-03",
"status": "A",
"authorized_official_last_name": "HAMAMEH",
"authorized_official_first_name": "MAZEN",
"authorized_official_middle_name": "N",
"authorized_official_title_or_position": "MEDICAL PROVIDER",
"authorized_official_telephone_number": "734-839-6610",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics, Adolescent Medicine",
"state": "MI",
"license": "5101016795",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE NETWORK",
"identifier": "1215142153",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1215142153",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERICAL",
"identifier": "1215142153",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
"identifier": "1215142153",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dearborn Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.