Fadi Samer Mousa Ayoub, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4351052672 Issued in MI

Practice address

22250 Providence Dr. 3PMB Suite #301
22250 Providence Dr. 3PMB Suite #301
Southfield, MI 48075-4818

Phone

(248) 849-3281

Fax

(248) 849-5449

NPI assigned

May 20, 2024

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

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1689413858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR. 3PMB SUITE #301",
            "address_2": "22250 PROVIDENCE DR. 3PMB SUITE #301",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-3281",
            "fax_number": "248-849-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR. 3PMB SUITE #301",
            "address_2": "22250 PROVIDENCE DR. 3PMB SUITE #301",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-3281",
            "fax_number": "248-849-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYOUB",
        "first_name": "FADI",
        "middle_name": "SAMER MOUSA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4351052672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amal Ayad, TLLP
• Titilayo Ayanwola, M.P.H., R.D., L.D.
• Christina Ayar
• Rebekah Ayers
• James Aylmer
• Sonya Ayoub, NP
• Aimee E Azain, RN
• Rascha Azakir, LMSW
• Mustafa Azam, MD
• Azhar a. Esho M.D.,PC.,

• Internal Medicine Physician in Southfield, MI
• Providers in Southfield, 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 Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.