Fathalla, Basil M

Fathalla, Basil M is an individual health care provider with primary practice located at 3901 Beaubien St Children'S Hospital Of Mi, Detroit MI 48201-2119. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Rheumatology, which is considered as his primary health care specialty. Fathalla, Basil M can be contacted via phone (215) 427-5094.

Contact Information

Primary practice address
3901 Beaubien St Children'S Hospital Of Mi Detroit MI 48201-2119
Phone: (215) 427-5094
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Rheumatology 2080P0216X MD427787 Pennsylvania

Profile Details

NPI number 1205879954
LBN Legal business name Fathalla, Basil M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated May 28th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205879954 NPPES
Pennsylvania MEDICAID 1014672880001

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