Healthcare Provider Details

I. General information

NPI: 1427944784
Provider Name (Legal Business Name): SEYEDEH SIMA DARYABARI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2025
Last Update Date: 06/14/2025
Certification Date: 06/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6245 INKSTER RD
GARDEN CITY MI
48135-4001
US

IV. Provider business mailing address

941 UNIVERSITY VLG
SALT LAKE CITY UT
84108-3444
US

V. Phone/Fax

Practice location:
  • Phone: 734-458-3300
  • Fax:
Mailing address:
  • Phone: 801-739-3790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: