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MOHAMAD A DAKLALLAH MD
NPI 1578187449
Student in an Organized Health Care Education/Training Program in Detroit, MI

Active since June 05, 2020PECOS Enrolled
2799 W GRAND BLVD # 1, DETROIT, MI 48202(313) 916-1888 Get Directions Write a Review

NPPES record last updated: November 9, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 9, 2021, Sep 10, 2021, Jun 5, 2020 (3 updates tracked since 2020).

About Mohamad A Daklallah Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOHAMAD A DAKLALLAH MD (NPI 1578187449) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1578187449
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMOHAMAD A DAKLALLAHCredential: MD
Location Address2799 W GRAND BLVD # 1Detroit, MI 48202-2689
Mailing Address2799 W Grand Blvd # 1Detroit, MI 48202-2689 · (313) 717-1615
Phone(313) 916-1888
Sole ProprietorNo
Enumeration DateJune 5, 2020
Last NPPES UpdateNovember 9, 20213 updates tracked since enumeration
NPPES CertifiedNovember 9, 2021
✔ NPI 1578187449 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2799 W GRAND BLVD # 1, Detroit, MI 48202
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mohamad A Daklallah Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HARI S IYER MD
Internal Medicine
2799 W GRAND BLVD # 1
DETROIT, MI 48202
Wayne County (313) 916-1888

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mohamad Daklallah's NPI number?

The NPI number for Mohamad Daklallah is 1578187449. It was assigned to this individual provider in the NPPES registry on June 5, 2020.

Where is Mohamad Daklallah located?

Mohamad Daklallah practices at 2799 W Grand Blvd # 1, Detroit, MI 48202. The listed phone number is (313) 916-1888.

What is Mohamad Daklallah's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Mohamad Daklallah enrolled in Medicare?

Yes. Mohamad Daklallah is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mohamad Daklallah was last updated on November 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.