Individual provider Active NPI

Fnu Fawaz Mohammed

  • Internal Medicine Physician
  • Pontiac, MI
National Provider Identifier
1598405342
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
TP154 Issued in KY
Practice address
44405 Woodward Ave
Pontiac, MI 48341-5023
Phone
(248) 858-3000
NPI assigned
Mar 30, 2022
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TP154 KY Primary

Addresses

Primary practice location

44405 Woodward Ave
Pontiac, MI 48341-5023

Mailing address

44405 Woodward Ave
Pontiac, MI 48341-5023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20241212001868 KY Practitioner - Internal Medicine 4385007772 Reassigns benefits to 6 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TP154KYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jane Todd Crawford Memorial Hospital, Inc. Current Accepting new patients
Jane Todd Crawford Memorial Hospital, Inc. CurrentSince Nov 25, 2024 Accepting new patients
Casey County Hospital District CurrentSince Nov 25, 2024 Accepting new patients
Jane Todd Crawford Memorial Hospital, Inc. CurrentSince Nov 25, 2024 Accepting new patients
Casey County Hospital District CurrentSince Nov 25, 2024 Accepting new patients

Locations

290 Industrial Park Rd
Greensburg, KY 42743
Phone (270) 634-1921

310 Industrial Park Rd
Greensburg, KY 42743
Phone (270) 299-2286

187 Wolford Ave
Liberty, KY 42539
Phone (606) 787-5044

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/caseyco-4151b385
  • FHIR API: https://fhir-usa.unify.chbase.com/org/janetod-f1571d3c

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1598405342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023",
            "telephone_number": "248-858-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMED",
        "first_name": "FNU FAWAZ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "TP154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.