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NPI Code Detail

MEDICARE: DR. FARRAH HAFEEZ D.O

MEDICARE:  DR. FARRAH  HAFEEZ  D.O
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician5101019545MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154610335
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FARRAH HAFEEZ D.O
Provider Business Mailing Address
First Line : 80600 VAN DYKE RD
Second Line :
City : BRUCE TWP
State : MI
Zip : 48065-1333
Country : US
Telephone Number : 810-798-6560
Fax Number :
Provider Business Practice Location Address
First Line : 80600 VAN DYKE RD
Second Line :
City : BRUCE TWP
State : MI
Zip : 48065-1333
Country : US
Telephone Number : 810-798-6560
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2011
Last Update Date : 04/02/2021

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Directions to “ DR. FARRAH HAFEEZ D.O” Practice Location

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