Individual provider Active NPI

Mohammed Doklaijah, MD

  • Pediatric Cardiology Physician
  • Ann Arbor, MI
National Provider Identifier
1790410827
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
4301513681 Issued in MI
Practice address
1540 E. Hospital Drive
CW 11-715Z, SPC 4204
Ann Arbor, MI 48109-4204
Phone
(734) 936-4038
NPI assigned
Jul 21, 2022
Last updated
Jul 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatric Cardiology Physician 2080P0202X 4301513681 MI Primary

Addresses

Primary practice location

1540 E. Hospital Drive
CW 11-715Z, SPC 4204
Ann Arbor, MI 48109-4204

Mailing address

1540 E. Hospital Drive
CW 11-715Z, SPC 4204
Ann Arbor, MI 48109-4204
Phone (734) 936-4038

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 Medicine

State licenses

LicenseStateTypeSpecialty
4301513681MIMDPediatric Cardiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1790410827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 E. HOSPITAL DRIVE",
            "address_2": "CW 11-715Z, SPC 4204",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481094204",
            "telephone_number": "734-936-4038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 E. HOSPITAL DRIVE",
            "address_2": "CW 11-715Z, SPC 4204",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481094204",
            "telephone_number": "734-936-4038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOKLAIJAH",
        "first_name": "MOHAMMED",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MI",
            "license": "4301513681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; 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.