Healthcare Provider Details

I. General information

NPI: 1316128986
Provider Name (Legal Business Name): OLIVER ADRIAN VARBAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2007
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W GRAND BLVD # K8W803
DETROIT MI
48202-2689
US

IV. Provider business mailing address

2799 W GRAND BLVD # K8W-803
DETROIT MI
48202-2608
US

V. Phone/Fax

Practice location:
  • Phone: 313-916-9782
  • Fax: 313-879-4163
Mailing address:
  • Phone: 313-916-9782
  • Fax: 313-879-4163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4301099577
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number128095
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: