Cathedral Community Medical Clinic PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301064977 Issued in MI

Legal business name

CATHEDRAL COMMUNITY MEDICAL CLINIC PC

Practice address

26515 Baldwin St
Dearborn Heights, MI 48127-1908

Phone

(313) 205-0909

Fax

(313) 562-0751

NPI assigned

Aug 5, 2006

Last updated

Dec 9, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Fady Fayad, M.D.NPI 1205862612

Title

Owner

Phone

(313) 205-0909

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

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.

• Fady Fayad Fayad, M.D.

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1205862612
  Authorized official Same address or phone
• Zakiya Antoine, D.O.

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1477868719
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291852800000",
    "number": "1649289844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26515 BALDWIN ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481271908",
            "telephone_number": "313-205-0909",
            "fax_number": "313-562-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26515 BALDWIN ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481271908",
            "telephone_number": "313-205-0909",
            "fax_number": "313-562-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHEDRAL COMMUNITY MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2010-12-09",
        "status": "A",
        "authorized_official_last_name": "FAYAD",
        "authorized_official_first_name": "FADY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-205-0909",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301064977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3347295T",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marsha Carr, MA,CCC-SLP
• Shantae Carter
• Elizabeth Anne Cary, PT, DPT
• Caudell Chiropractic Clinic
• Glenn A Caudell, DC
• Hussein Chahin
• Hassan Ali Chahrour, PHARMD
• Ali Chammout

• Internal Medicine Physician in Dearborn Heights, MI
• Providers in Dearborn Heights, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; 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.