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NPI Code Detail

MEDICARE: AMITABH PAHARIA M.D.

MEDICARE: AMITABH PAHARIA M.D.
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 Physician4301064576MI

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 : 1316918899
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMITABH PAHARIA M.D.
Provider Business Mailing Address
First Line : 4420 E DAVISON ST
Second Line :
City : DETROIT
State : MI
Zip : 48212-1744
Country : US
Telephone Number : 313-369-1500
Fax Number : 313-369-1205
Provider Business Practice Location Address
First Line : 4420 E DAVISON ST
Second Line :
City : DETROIT
State : MI
Zip : 48212-1744
Country : US
Telephone Number : 313-369-1500
Fax Number : 313-369-1205
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2006
Last Update Date : 03/02/2014

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Directions to “ AMITABH PAHARIA M.D.” Practice Location

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