Basil M Fathalla
Pediatric Rheumatologist
3901 Beaubien St Children's Hospital Of Mi
Detroit
, Michigan 48201-2119
Basil M Fathalla
Pediatric Rheumatologist
3901 Beaubien St Children's Hospital Of Mi
Detroit
, Michigan 48201-2119
(313) 966-5051
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About
Features
Specialties
- Pediatric Rheumatologist
Languages spoken
- English
Location
First Address
- Basil M Fathalla
- 4201 St. Antoine University Pediatricians Uhc 6f Mailbox# 226
- Detroit, MI
- Zip : 48201-4139
- Phone : (313) 966-5051
Second Address
- Basil M Fathalla
- 3901 Beaubien St Children's Hospital Of Mi
- Detroit, MI
- Zip : 48201-2119
- Phone : (215) 427-5094
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Is Basil M Fathalla accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0216X | Pediatric Rheumatologist | MD427787 | PA |
National Provider Identifier
| NPI | 1205879954 |
|---|---|
| Provider Name | Basil M Fathalla |
| First Address | Detroit, MI 48201-4139 |
| Second Address | Detroit, MI 48201-2119 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/06/2006 |
| Last Update Date | 28/05/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1014672880001 | (05) | PA |
| G93282 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.