Healthcare Provider Details

I. General information

NPI: 1396869665
Provider Name (Legal Business Name): FADI MUSA ABUHMAID MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16407 SOUTHFIELD RD
ALLEN PARK MI
48101
US

IV. Provider business mailing address

16407 SOUTHFIELD RD STE A
ALLEN PARK MI
48101-2571
US

V. Phone/Fax

Practice location:
  • Phone: 313-271-3000
  • Fax: 313-271-3003
Mailing address:
  • Phone: 313-271-3000
  • Fax: 313-271-3003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number4301088350
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301088350
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: