Active NPI
Mohammed Fawaz, PHARMD
- Pharmacist
- Dearborn, MI
National Provider Identifier
1861998114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302044235
- Practice address
- 22361 W Village Dr
Dearborn, MI 48124-2227 - Phone
- (313) 350-5859
- NPI assigned
- Apr 4, 2018
- Sex
- Male
- 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 | 5302044235 | MI | Primary |
Addresses
Primary practice location
22361 W Village Dr
Dearborn, MI 48124-2227
Mailing address
6969 Nightingale St
Dearborn Heights, MI 48127-2132
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 Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302044235 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Health Pharmacy LLC | Pharmacist | Current | Accepting new patients |
| Modern Health Pharmacy of Birmingham | Current | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacist
- Canton, MI
- NPI 1447734496
-
- Pharmacy
- Birmingham, MI
- NPI 1831747096
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555545600000",
"number": "1861998114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6969 NIGHTINGALE ST",
"city": "DEARBORN HEIGHTS",
"state": "MI",
"postal_code": "481272132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22361 W VILLAGE DR",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481242227",
"telephone_number": "313-350-5859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAWAZ",
"first_name": "MOHAMMED",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-04",
"last_updated": "2019-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302044235",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.