Basil M Fathalla

M.D. | Pediatric Rheumatology | Male

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Complete Profile:

Basil M Fathalla basic information including his official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Pediatric Rheumatology
Provider Name :	Basil M Fathalla
Credential :	M.D.
Gender :	Male

Business Address:

Basil M Fathalla address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	3901 Beaubien St, Children's Hospital Of Mi Detroit, MI, 48201-2119 United States
Phone Number :	215-427-5094

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1205879954
NPI Entity Type :	Individual
First Enrolment Date :	13 Jun, 2006
Last Updated On :	28 May, 2009

Medicare Participation:

Basil M Fathalla participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	2264446905
Medicare Enrollment ID :	I20090130000206
Primary Specialty :	Pediatric Medicine
Medical School :	Other
Graduation Year :	1995
Accepts Medicare?	Yes. Basil M Fathalla accepts medicare insurance.

Group Practice Association:

Basil M Fathalla is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Basil M Fathalla is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
University Pediatricians	9638070568	85	3901 Beaubien St Detroit, MI - 482012119 Ph: 3137455870	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Basil M Fathalla are as mentioned. Primary taxonomy code for Basil M Fathalla, M.D. is 2080P0216X (Pediatrics Pediatric Rheumatology).

Taxonomy Code	Speciality	Primary	License No.	State
2080P0216X	Pediatrics Pediatric Rheumatology	Yes	MD427787	PA

Legacy Identifiers:

Other legacy medical identifiers of Basil M Fathalla such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.

Identifier	Identifier Type	State	Issuer
1014672880001	MEDICAID	PA

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	4201 St. Antoine, University Pediatricians Uhc 6f Mailbox# 226 Detroit, MI, 48201-4139 United States
Phone Number :	313-966-5051

Business Location:

Patients can refer following map for directions to Basil M Fathalla practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.