Kassem Mahmoud Hallak, MD MS

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301062401 Issued in MI

Practice address

616 Meijer St
Charlotte, MI 48813

Phone

(517) 543-7800

Fax

(517) 543-7900

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine, Master of Science

State licenses

Practice roles

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

• Charlotte Medical Center & Urgent Care

  • Urgent Care Clinic/Center
  • Charlotte, MI
  • NPI 1780904417
  NPD (past) Authorized official
• Charlotte Family and Urgent Care Center, PC

  • Urgent Care Clinic/Center
  • Charlotte, MI
  • NPI 1417385873
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262908800000",
    "number": "1629140447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 327",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "48813",
            "telephone_number": "517-543-7800",
            "fax_number": "517-543-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 MEIJER ST",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "48813",
            "telephone_number": "517-543-7800",
            "fax_number": "517-543-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLAK",
        "first_name": "KASSEM",
        "middle_name": "MAHMOUD",
        "name_prefix": "Dr.",
        "credential": "MD MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2010-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301062401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104863352",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin M Griffith, NP-C
• Michelle Kay Guilford, MA, CCC-SLP
• Sarah Kathryn Guy
• Megan Hackbarth
• Debbie Haymowattee Hallak, DO
• Heidi Hansen, D.C.
• Kathleen Anne Hartman-McCarthy, LCSW
• Roberta Jo Hartung
• Benjamin Haskel, RPH
• Rebecca Sue Hawkins, MA, TLLP, CAADC

• Family Medicine Physician in Charlotte, MI
• Providers in Charlotte, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.