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General NPI Number Information
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NPI Number | 1023360971
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Entity Type | Organization
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Legal Business Name | FRANK M FAYZ MD PC
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Dates
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Enumeration Date | 10/02/2012
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Last Update Date | 10/02/2012
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Provider Practice Location Address
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Address Line | 600 TOWN CENTER DR SUITE 1275
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City | DEARBORN
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State | MI
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Zip | 48126-2718
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Country | US
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Telephone | 313-680-2173
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Fax |
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Provider Business Mailing Address
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Address Line | 600 TOWN CENTER DR SUITE 1275
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City | DEARBORN
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State | MI
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Zip | 48126-2718
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Country | US
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Telephone | 313-680-2173
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRANK M FAYZ
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Credential | M.D.
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Telephone | 313-680-2173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4301056038
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License Number State | MI
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