Healthcare Provider Details

I. General information

NPI: 1265807333
Provider Name (Legal Business Name): BRIGHT FUTURE PEDIATRICS P L L C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2015
Last Update Date: 01/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 S LINDEN RD STE 500
FLINT MI
48532-4069
US

IV. Provider business mailing address

1125 S LINDEN RD STE 500
FLINT MI
48532-4069
US

V. Phone/Fax

Practice location:
  • Phone: 810-262-2150
  • Fax: 810-732-3199
Mailing address:
  • Phone: 810-262-2150
  • Fax: 810-732-3199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: HYTHAM H FADL
Title or Position: OWNER
Credential: MD
Phone: 810-394-0688