Individual provider Active NPI

Alirida Baidoun

  • Pharmacist
  • Livonia, MI
National Provider Identifier
1770114621
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302041477 Issued in MI
Practice address
19120 Middlebelt Rd
Livonia, MI 48152-2102
Phone
(313) 515-9594
NPI assigned
Jan 29, 2020
Last updated
Jan 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302041477 MI Primary

Addresses

Primary practice location

19120 Middlebelt Rd
Livonia, MI 48152-2102

Mailing address

21 Williamson CT
Dearborn, MI 48126-2126

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

State licenses

LicenseStateTypeSpecialty
5302041477MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1770114621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WILLIAMSON CT",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19120 MIDDLEBELT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522102",
            "telephone_number": "313-515-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIDOUN",
        "first_name": "ALIRIDA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302041477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; 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.