MEDICARE: BASHIR TARRAF, OD, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1568190718
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BASHIR TARRAF, OD, PC

Provider Business Mailing Address
First Line	:	15120 MICHIGAN AVE STE D
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48126-3768
Country	:	US
Telephone Number	:	313-982-2425
Fax Number	:

Provider Business Practice Location Address
First Line	:	15120 MICHIGAN AVE STE D
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48126-3768
Country	:	US
Telephone Number	:	313-982-2425
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. BASHIR TARRAF
Credential	:	OD
Telephone Number	:	313-982-2425

Provider Enumeration Date	:	08/15/2022
Last Update Date	:	08/16/2022

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