Individual provider Active NPI

Mohamad G Beydoun, PHARMD

  • Pharmacist
  • Comstock Park, MI
National Provider Identifier
1679048995
Registry record updated Oct 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302042254 Issued in MI
Practice address
3901 Alpine Ave NW
Comstock Park, MI 49321-8350
Phone
(616) 647-9302
NPI assigned
Oct 13, 2018
Last updated
Oct 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302042254 MI Primary

Addresses

Primary practice location

3901 Alpine Ave NW
Comstock Park, MI 49321-8350

Mailing address

224 Robin CT
Big Rapids, MI 49307-2330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
5302042254MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1539388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539388800000",
    "number": "1679048995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 ROBIN CT",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 ALPINE AVE NW",
            "city": "COMSTOCK PARK",
            "state": "MI",
            "postal_code": "493218350",
            "telephone_number": "616-647-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYDOUN",
        "first_name": "MOHAMAD",
        "middle_name": "G",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-13",
        "last_updated": "2018-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302042254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Comstock Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2018; 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.