Organization Active NPI

M Al-Jabban MD PLC

  • Internal Medicine Physician
  • Flint, MI
National Provider Identifier
1497015325
Registry record updated May 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301054851 Issued in MI
Legal business name
M AL-JABBAN MD PLC
Practice address
5232 Richfield Rd
Flint, MI 48506-2182
Phone
(810) 736-0970
Fax
(810) 736-3241
NPI assigned
May 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2012

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

Authorized official

Name
Mohamad Al-Jabban, MDNPI 1831291764
Title
Owner
Phone
(810) 736-0970

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 4301054851 MI Primary

Addresses

Primary practice location

5232 Richfield Rd
Flint, MI 48506-2182

Mailing address

5232 Richfield Rd
Flint, MI 48506-2182
Phone (810) 736-0970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120626000039 MI Part B Supplier - Clinic/Group Practice 2860657889 Receives reassigned benefits from 3 practitioners
Practice locations: Flint, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337904000000",
    "number": "1497015325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5232 RICHFIELD RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485062182",
            "telephone_number": "810-736-0970",
            "fax_number": "810-736-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5232 RICHFIELD RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485062182",
            "telephone_number": "810-736-0970",
            "fax_number": "810-736-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M AL-JABBAN MD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-25",
        "last_updated": "2012-05-25",
        "status": "A",
        "authorized_official_last_name": "AL-JABBAN",
        "authorized_official_first_name": "MOHAMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-736-0970",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301054851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; 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.