Dr Fadee Kutom, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Flint, Michigan. His current practice location is
401 S Ballenger Hwy, Flint, Michigan. You can reach out to his office (for appointments etc.) via phone at
(810) 342-2000.
Dr Fadee Kutom is licensed to practice in Michigan (license number 4301507051) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1245717909.
Physician's Profile
Full Name | Dr Fadee Kutom |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 401 S Ballenger Hwy, Flint, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1245717909
- Provider Enumeration Date: 07/25/2018
- Last Update Date: 06/15/2022
Medicare PECOS Information:
- PECOS PAC ID: 8921428277
- Enrollment ID: I20201026002553
Medical Identifiers
Medical identifiers for Dr Fadee Kutom such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1245717909 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | 125.072953 (Illinois) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | 4301507051 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Fadee Kutom is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Fadee Kutom, MD 401 S Ballenger Hwy, Flint, MI 48532-3638 Ph: (810) 342-2000 | Dr Fadee Kutom, MD 401 S Ballenger Hwy, Flint, MI 48532-3638 Ph: (810) 342-2000 |
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