Mohammad Nadeemullah, M. D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

057016 Issued in MI

Practice address

2305 Genoa Business Park Dr
Suite 120
Brighton, MI 48114-7004

Phone

(810) 494-6800

Fax

(810) 229-4990

NPI assigned

Jun 13, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: mnadeemu@direct.dmc.org

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1821031576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 S LATSON RD",
            "address_2": "STE 200",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488437660",
            "telephone_number": "810-494-6800",
            "fax_number": "810-229-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 GENOA BUSINESS PARK DR",
            "address_2": "SUITE 120",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147004",
            "telephone_number": "810-494-6800",
            "fax_number": "810-229-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADEEMULLAH",
        "first_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "057016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4661698",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Brighton, MI
• Providers in Brighton, 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 Apr 11, 2019; 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.