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General NPI Number Information
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NPI Number | 1275736936
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Entity Type | Individual
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Provider Name | VICTOR SAMIR FARIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2007
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 1010 N CAMPBELL RD SUITE #3
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City | ROYAL OAK
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State | MI
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Zip | 48067-1570
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Country | US
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Telephone | 248-850-8395
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Fax | 248-850-8495
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Provider Business Mailing Address
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Address Line | 13403 W 7 MILE RD
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City | DETROIT
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State | MI
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Zip | 48235-1387
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Country | US
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Telephone | 313-308-2444
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Fax | 313-739-6066
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1865828
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 1865828
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License Number State | MI
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