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General NPI Number Information
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NPI Number | 1497741177
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Entity Type | Individual
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Provider Name | ARDESHIR IRANI MD
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Gender | Male
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 208 W HIGHLAND RD STE 100
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City | HIGHLAND
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State | MI
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Zip | 48357-4504
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Country | US
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Telephone | 586-773-1823
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Fax | 586-773-1211
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Provider Business Mailing Address
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Address Line | 208 W HIGHLAND RD STE 100
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City | HIGHLAND
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State | MI
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Zip | 48357-4504
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Country | US
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Telephone | 586-773-1823
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Fax | 586-773-1211
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | AI064238
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License Number State | MI
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