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

Moises Fajardo

Individual provider Family Nurse Practitioner · NPI 1740683069

Moises Fajardo is a Nurse Practitioner in Clawson, Michigan. Qualified in 2014, 12 years ago. Practices with Beaumont Medical Group- Specialty Services, a 858-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
12
Licensed in
MI
In the registry since
2014
Specialties on file
2
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Practice location Address checks out

1402 W 14 Mile Rd
Clawson, MI 48017-1499
Phone: (866) 389-2727
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 4704267838 (MI)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 4704267838 (MI)

Record details

NPI number1740683069
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 1, 2014
Last updated in NPPESOctober 22, 2020
Certification dateOctober 22, 2020
Mailing address2445 Claymont Dr, Troy, MI 48098-2493

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Beaumont Medical Group- Specialty Services — 858 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Clawson