MEDICARE: JAMAL FADHEL 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	207R00000X	Internal Medicine Physician	4301501862	MI

General Provider Information

NPI Number	:	1790212637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMAL FADHEL M.D.

Provider Business Mailing Address
First Line	:	5810 GRATIOT RD
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48638-6063
Country	:	US
Telephone Number	:	989-899-7254
Fax Number	:

Provider Business Practice Location Address
First Line	:	5810 GRATIOT RD
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48638-6063
Country	:	US
Telephone Number	:	989-899-7254
Fax Number	:	989-899-7256

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

Provider Enumeration Date	:	05/22/2017
Last Update Date	:	02/11/2026

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