Healthcare Provider Details

I. General information

NPI: 1992790588
Provider Name (Legal Business Name): MARGARET E FADANELLI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22201 MOROSS RD 252
DETROIT MI
48236-2169
US

IV. Provider business mailing address

6574 NORTHPOINT DR
TROY MI
48085-1420
US

V. Phone/Fax

Practice location:
  • Phone: 313-343-4411
  • Fax: 313-343-4412
Mailing address:
  • Phone: 586-662-3666
  • Fax: 586-210-8696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number4301060624
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: