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Contact Information

BASIL M FATHALLA, MD
3901 BEAUBIEN ST
CHILDREN'S HOSPITAL OF MI
DETROIT, MI48201-2119
 Phone: 215-427-5094
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Rheumatology

2080P0216X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for BASIL M FATHALLA · (Male)

NPI Number 1205879954
Status Active
Credentials MD
Entity Individual
Enumeration date 06/13/2006
Last updated 05/28/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • PA License # MD427787
  • PA Medicaid 1014672880001
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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