Individual provider Active NPI

Mohamed Noureddine, MD

  • Student in an Organized Health Care Education/Training Program
  • Livonia, MI
National Provider Identifier
1447955141
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
36475 Five Mile Rd
Livonia, MI 48154-1971
Phone
(734) 853-5690
NPI assigned
Apr 3, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MI Primary

Addresses

Primary practice location

36475 Five Mile Rd
Livonia, MI 48154-1971

Mailing address

728 N Charlesworth St
Dearborn Heights, MI 48127-3612
Phone (313) 478-7550

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
I20230713000339 MI Order and Referring Only - Family PracticePractitioner - Family Practice 2961862677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: mnoureddine2737397@direct.trinity-health.org
  • Direct secure messaging: mnoureddine794286@direct.hfhs.org

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1447955141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 N CHARLESWORTH ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273612",
            "telephone_number": "313-478-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36475 FIVE MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541971",
            "telephone_number": "734-853-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOUREDDINE",
        "first_name": "MOHAMED",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.