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General NPI Number Information
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NPI Number | 1154703361
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Entity Type | Individual
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Provider Name | FARHAD ALI AMIRI DO
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Gender | Male
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Dates
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Enumeration Date | 06/24/2015
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 18000 W 9 MILE RD STE 750
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4020
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Country | US
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Telephone | 248-607-7190
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Fax | 248-607-7191
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Provider Business Mailing Address
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Address Line | 18000 W 9 MILE RD STE 750
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4020
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Country | US
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Telephone | 248-607-7190
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Fax | 248-607-7191
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | DO2563
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | OT016570
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 5101022725
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License Number State | MI
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