MEDICARE: MOHAMED FAKIH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	4301511338	MI

General Provider Information

NPI Number	:	1003437856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED FAKIH M.D.

Provider Business Mailing Address
First Line	:	2547 MONROE ST
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-3013
Country	:	US
Telephone Number	:	313-791-8300
Fax Number	:	313-791-8302

Provider Business Practice Location Address
First Line	:	2547 MONROE ST
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-3013
Country	:	US
Telephone Number	:	313-745-4195
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2020
Last Update Date	:	09/30/2025

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