| Fd Farah Mi Pllc | |
|
1701 South Blvd E Rochester Hills MI 48307-6122 | |
| (586) 580-0760 | |
| Not Available |
| Full Name | Fd Farah Mi Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1701 South Blvd E, Rochester Hills, Michigan |
| Authorized Official Name and Position | Farah Rafik Dawood-farah (OWNER) |
| Authorized Official Contact | 7818567000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fd Farah Mi Pllc Po Box 303 Royal Oak MI 48068-0303 Ph: (781) 856-7000 | Fd Farah Mi Pllc 1701 South Blvd E Rochester Hills MI 48307-6122 Ph: (586) 580-0760 |
| NPI Number | 1730528258 |
|---|---|
| Provider Enumeration Date | 06/18/2013 |
| Last Update Date | 11/27/2017 |
| Medicare PECOS PAC ID | 3971739368 |
|---|---|
| Medicare Enrollment ID | O20131113000163 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730528258 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 4301065535 (Michigan) | Primary |
| Provider Name | Farah R Dawood Farah |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1841245263 PECOS PAC ID: 1052397387 Enrollment ID: I20131113000254 |
| Provider Name | Mazen Al Mushref |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1356781256 PECOS PAC ID: 2567605199 Enrollment ID: I20180710003279 |
| Provider Name | Kristin Michelle Kennaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427611052 PECOS PAC ID: 5991033052 Enrollment ID: I20190827003445 |
| Provider Name | Teia Lee Irwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740891639 PECOS PAC ID: 8921410457 Enrollment ID: I20201207002240 |
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