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General NPI Number Information
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NPI Number | 1033875661
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Entity Type | Individual
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Provider Name | FATIMA BAYDOUN
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Gender | Female
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Dates
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Enumeration Date | 11/09/2021
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 15538 MICHIGAN AVE
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City | DEARBORN
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State | MI
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Zip | 48126-2901
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Country | US
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Telephone | 877-932-3862
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Fax | 313-800-7081
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Provider Business Mailing Address
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Address Line | PO BOX 701393
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City | PLYMOUTH
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State | MI
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Zip | 48170-0964
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Country | US
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Telephone | 313-670-0741
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Fax | 313-800-7081
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 4704363333
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 4704362333
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License Number State | MI
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