Healthcare Provider Details

I. General information

NPI: 1538399613
Provider Name (Legal Business Name): DARIUSH J ORANDI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2009
Last Update Date: 08/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 HEALTH DR SW STE 1400
WYOMING MI
49519-9681
US

IV. Provider business mailing address

PO BOX 3140
GRAND RAPIDS MI
49501-3140
US

V. Phone/Fax

Practice location:
  • Phone: 616-794-6301
  • Fax: 616-504-1702
Mailing address:
  • Phone: 616-459-6867
  • Fax: 616-726-1180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number55742
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301095171
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number4301095171
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: