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General NPI Number Information
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NPI Number | 1902014509
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Entity Type | Individual
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Provider Name | ADRISS ESSAWEE FARAJ MD
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Gender | Male
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 03/01/2021
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Provider Practice Location Address
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Address Line | 200 W CENTER ST
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City | ALMA
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State | MI
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Zip | 48801-2207
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Country | US
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Telephone | 989-463-5876
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Fax | 989-466-5956
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Provider Business Mailing Address
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Address Line | 200 W CENTER ST
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City | ALMA
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State | MI
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Zip | 48801-2207
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Country | US
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Telephone | 989-463-5876
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Fax | 989-466-5956
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301087325
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License Number State | MI
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