Mmfallouh MD LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD443377 Issued in PA

Legal business name

MMFALLOUH MD LLC

Doing business as

M. M. Fallouh M.D. LLC

Practice address

6970 Germantown Ave
Philadelphia, PA 19119-2114

Phone

(484) 448-2203

Fax

(484) 448-2203

NPI assigned

Jan 11, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Mohanad M Fallouh, M.D.NPI 1619915527

Title

President

Phone

(989) 560-1104

Specialties & licenses 1

Addresses

Other names 1

• M. M. FALLOUH M.D. LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mohanad M Fallouh, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1619915527
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666569600000",
    "number": "1538406475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 NORRISTOWN RD",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194222802",
            "telephone_number": "989-560-1104",
            "fax_number": "484-448-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6970 GERMANTOWN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191192114",
            "telephone_number": "484-448-2203",
            "fax_number": "484-448-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMFALLOUH MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-11",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A",
        "authorized_official_last_name": "FALLOUH",
        "authorized_official_first_name": "MOHANAD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-560-1104",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD443377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M. M. FALLOUH M.D. LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Seda Mkrticheva, MS, LBS
• Vongai Christine Mlambo, MD
• MLN Rehab., Inc.
• Alan Joseph Mlodzienski, DPM
• Ergisa Mlova, DPT
• MMR Group (26th & lehigh pharmacy)
• MMT Logistics Inc
• Mnap Diagnostic Imaging LLC
• Mnap Diagnostic Imaging, LLC
• Mnap Medical Solutions (MNAP Diagnostic Center)

• Internal Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.