1750340576 NPI number — FAROUK SALAHI M.D.

Table of content: FAROUK SALAHI M.D. (NPI 1750340576)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750340576 NPI number — FAROUK SALAHI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALAHI
Provider First Name:
FAROUK
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750340576
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/31/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
67200 VAN DYKE RD
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48095-1463
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
586-752-9895
Provider Business Mailing Address Fax Number:
586-752-0740

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2708 S ROCHESTER RD
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
ROCHESTER HILLS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48307-4577
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-852-0797
Provider Business Practice Location Address Fax Number:
586-752-0740
Provider Enumeration Date:
03/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  4301051155 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0636090 . This is a "BCN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 105202457 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0636090 . This is a "BCBS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: E25878 . This is a "HAP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com