Active NPI
Susan Fadlallah
- Pharmacist
- Detroit, MI
National Provider Identifier
1811006794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 025932
- Practice address
- 20526 Plymouth Rd
Detroit, MI 48228-1201 - Phone
- (313) 838-2555
- Fax
- (313) 838-1320
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 025932 | MI | Primary |
Addresses
Primary practice location
20526 Plymouth Rd
Detroit, MI 48228-1201
Mailing address
20526 Plymouth Rd
Detroit, MI 48228-1201
Phone (313) 838-2555
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
| License | State | Type | Specialty |
|---|---|---|---|
| 025932 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201737600000",
"number": "1811006794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20526 PLYMOUTH RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482281201",
"telephone_number": "313-838-2555",
"fax_number": "313-838-1320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20526 PLYMOUTH RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482281201",
"telephone_number": "313-838-2555",
"fax_number": "313-838-1320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FADLALLAH",
"first_name": "SUSAN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2008-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "025932",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.