Mohamad Jawad N/a Badreddine

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302413790 Issued in MI

Practice address

3601 Clyde Park Ave SW
Wyoming, MI 49509-4023

Phone

(616) 257-6641

NPI assigned

Mar 13, 2023

Last updated

Mar 13, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Best Choice Pharmacy LLC

  • Community/Retail Pharmacy
  • Dearborn, MI
  • NPI 1063391365
  NPD Authorized official
• Woodward Detroit CVS, L.L.C.

  dba CVS Pharmacy #08290

  • Pharmacy
  • Wyoming, MI
  • NPI 1366541666
  NPD (past)

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1639870298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 CLYDE PARK AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495094023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 CLYDE PARK AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495094023",
            "telephone_number": "616-257-6641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADREDDINE",
        "first_name": "MOHAMAD JAWAD",
        "middle_name": "N/A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302413790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Ayers, DO
• Sarah Ayotte
• Scott Anthony Baar, FNP-C
• Bella Baazov, OTR/L
• Clare Bacon
• David M Bailey, LLMSW
• Patricia Jeanne Bain
• Ashveen Bains, DO
• Christina Bakalis
• Katherine Baker, FNP

• Pharmacist in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.