Healthcare Provider Details

I. General information

NPI: 1871892364
Provider Name (Legal Business Name): RYAN AHRIA PIROOZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2011
Last Update Date: 03/09/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36475 FIVE MILE RD
LIVONIA MI
48154-1971
US

IV. Provider business mailing address

4964 S RIDGESIDE CIR
ANN ARBOR MI
48105-9447
US

V. Phone/Fax

Practice location:
  • Phone: 734-655-2022
  • Fax:
Mailing address:
  • Phone: 734-255-2913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35.135957
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number4301098789
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number4301098789
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: