Active NPI
Michael Adel Basaly Tadros
- Pharmacist
- Simpsonville, SC
National Provider Identifier
1912489345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 37437
- Practice address
- 698 Fairview Road
Simpsonville, SC 29680 - Phone
- (864) 962-8991
- NPI assigned
- Sep 1, 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 | 37437 | SC | Primary |
Addresses
Primary practice location
698 Fairview Road
Simpsonville, SC 29680
Mailing address
125 Canebrake Drive
Greer, SC 29650
Phone (407) 624-6493
Other practice location 1
125 canebrake drive
Greer, SC 29650
Phone (407) 624-6493
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 |
|---|---|---|---|
| 37437 | SC | MD | Plastic Surgery within the Head & Neck (Otolaryngology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535760000000",
"number": "1912489345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 CANEBRAKE DRIVE",
"city": "GREER",
"state": "SC",
"postal_code": "29650",
"telephone_number": "407-624-6493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "698 FAIRVIEW ROAD",
"city": "SIMPSONVILLE",
"state": "SC",
"postal_code": "29680",
"telephone_number": "864-962-8991"
}
],
"practiceLocations": [
{
"address_1": "125 canebrake drive",
"address_purpose": "LOCATION",
"city": "Greer",
"state": "SC",
"postal_code": "29650",
"country_code": "US",
"telephone_number": "407-624-6493",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TADROS",
"first_name": "MICHAEL",
"middle_name": "ADEL BASALY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-01",
"last_updated": "2018-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "37437",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Simpsonville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.