Active NPI
Hossam Mohamad
- Pharmacist
- Dearborn Heights, MI
National Provider Identifier
1912727314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302416863
- Practice address
- 8710 N Beech Daly Rd
Dearborn Heights, MI 48127-5001 - Phone
- (313) 278-1000
- NPI assigned
- Oct 11, 2024
- 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 | 5302416863 | MI | Primary |
Addresses
Primary practice location
8710 N Beech Daly Rd
Dearborn Heights, MI 48127-5001
Mailing address
28850 Pardo St Apt 1
Garden City, MI 48135-2871
Phone (313) 588-0245
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 |
|---|---|---|---|
| 5302416863 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodward Detroit CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728604800000",
"number": "1912727314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28850 PARDO ST APT 1",
"city": "GARDEN CITY",
"state": "MI",
"postal_code": "481352871",
"telephone_number": "313-588-0245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8710 N BEECH DALY RD",
"city": "DEARBORN HEIGHTS",
"state": "MI",
"postal_code": "481275001",
"telephone_number": "313-278-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHAMAD",
"first_name": "HOSSAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-10-11",
"last_updated": "2024-10-11",
"certification_date": "2024-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302416863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.