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BUTOOL HISAM MD, MPH
NPI 1639012057
Student in an Organized Health Care Education/Training Program in Detroit, MI

Active since April 10, 2026
19460 GRAND RIVER AVE, DETROIT, MI 48223(313) 497-3515 Get Directions Write a Review

NPPES record last updated: April 10, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Butool Hisam Md, Mph NPPES

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

BUTOOL HISAM MD, MPH (NPI 1639012057) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since April 2026.

NPPES Registry Identity

NPI1639012057
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameBUTOOL HISAMCredential: MD, MPH
Location Address19460 GRAND RIVER AVEDetroit, MI 48223-1200
Mailing Address3300 16th St NwWashington, DC 20010-2269
Phone(313) 497-3515
Sole ProprietorNo
Enumeration DateApril 10, 2026
NPPES CertifiedMarch 27, 2026
✔ NPI 1639012057 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.
19460 GRAND RIVER AVE, Detroit, MI 48223
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Other Providers at the Same Location NPPES 20

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

ANATRUP INC.
Pharmacy (Community/Retail Pharmacy)
19460 GRAND RIVER AVE
DETROIT, MI 48223
Wayne County (313) 533-0560
KALIKA CORP.
Pharmacy (Community/Retail Pharmacy)
19460 GRAND RIVER AVE
DETROIT, MI 48223
Wayne County (313) 865-9494
PAUL ROTARIUS INC
Pharmacy (Community/Retail Pharmacy)
19460 GRAND RIVER AVE
DETROIT, MI 48223
Wayne County (313) 533-0560
NOOR RAED KHALEEL ALBARAQ MD
Student in an Organized Health Care Education/Training Program
19460 GRAND RIVER AVE
DETROIT, MI 48223
Wayne County (313) 387-1097
DR. CHARLTON CASTILLO LACERNA M.D.
Family Medicine
19460 GRAND RIVER AVE
DETROIT, MI 48223
Wayne County (313) 387-1097
ONYEKACHUKWU OLISEMEKA M.D.
Family Medicine
19460 GRAND RIVER AVE
DETROIT, MI 48223
Wayne County (313) 387-1097
REHAB ONE, INC.
Clinic/Center (Rehabilitation)
19460 GRAND RIVER AVE
DETROIT, MI 48223
Wayne County (248) 592-9029
NEWDIMENSIONS REHAB
Clinic/Center (Physical Therapy)
19460 GRAND RIVER AVE
DETROIT, MI 48223
Wayne County (313) 318-3749

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 Butool Hisam's NPI number?

The NPI number for Butool Hisam is 1639012057. It was assigned to this individual provider in the NPPES registry on April 10, 2026.

Where is Butool Hisam located?

Butool Hisam practices at 19460 Grand River Ave, Detroit, MI 48223. The listed phone number is (313) 497-3515.

What is Butool Hisam's specialty?

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

When was this NPI record last updated?

The NPPES record for Butool Hisam was last updated on April 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.