Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Butool Hisam, MD, MPH

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1639012057

Butool Hisam, MD, MPH is a Student in an Organized Health Care Education/Training Program in Detroit, Michigan. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
MPH — Master of Public Health
A graduate degree in population health.

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Practice location Address checks out

19460 Grand River Ave
Detroit, MI 48223-1200
Phone: (313) 497-3515
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1639012057
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD , MPH
Sole proprietorNo
NPI enumeratedApril 10, 2026
Last updated in NPPESApril 10, 2026
Certification dateMarch 27, 2026

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