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General NPI Number Information
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NPI Number | 1669730008
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Entity Type | Individual
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Provider Name | CASEY DARRAH M.D
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Gender | Male
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 10/21/2019
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Provider Practice Location Address
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Address Line | 24371 W 10 MILE RD
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City | SOUTHFIELD
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State | MI
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Zip | 48033-2929
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Country | US
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Telephone | 248-809-6088
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Fax |
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Provider Business Mailing Address
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Address Line | 34740 W 8 MILE RD APT 1
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City | FARMINGTON HILLS
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State | MI
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Zip | 48335-5111
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Country | US
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Telephone | 419-346-3043
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Fax |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 127592
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 4301101902
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License Number State | MI
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