| NPI Details | |
|---|---|
| NPI | 1134194509 |
| Enumeration Date | 02/21/2006 |
| Last Updated | 07/08/2007 |
| Entity Type | Healthcare Provider |
| Active | Over 12 years ago |
| Authorized Information | |
|---|---|
| Name | FARIDEH R. FARIDEH |
| Position | CEO |
| Phone | (248) 625-0300 |
| Fax | (248) 625-0363 |
| Practice Location | |
|---|---|
| 6770 DIXIE HWY SUITE 106 CLARKSTON MI, 48346-2087, US |
|
| Phone | (248) 625-0300 |
| Fax | (248) 625-0363 |
| Business Location | |
|---|---|
| 70 FULTON ST PONTIAC MI, 48341-2755, US |
|
| Phone | (248) 338-0300 |
| Fax | (248) 338-0663 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 2085R0001X |
| License State | |
| License Number | |
| Remove 1134194509 NPI Number | |
According to our database, Miro-clarkston NPI is 1134194509, taxonomy code is 2085R0001X Miro-clarkston physically located at 6770 Dixie Hwy, Clarkston MI, 48346-2087. NPI Number 1033115704 has the healthcare provider type.
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1134194509 NPI number is provided on an as is basis without warranty of any kind. 1134194509 is maintained by the National Plan & Provider Enumeration System. The contents of Miro-clarkston are for informational purposes only.
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