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NPI Code Detail

MEDICARE: DR. FARRAH LAVIOLETTE MD

MEDICARE:  DR. FARRAH  LAVIOLETTE  MD
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
12084A0401XAddiction Medicine (Psychiatry & Neurology) Physician4351046857MI
22084P0804XChild & Adolescent Psychiatry Physician4301508678MI
32084P0800XPsychiatry Physician4301508678MI

General Provider Information

NPI Number : 1740821339
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FARRAH LAVIOLETTE MD
Provider Business Mailing Address
First Line : 1407 ALLEN DR STE I
Second Line :
City : TROY
State : MI
Zip : 48083-4009
Country : US
Telephone Number : 248-971-0240
Fax Number : 248-780-3786
Provider Business Practice Location Address
First Line : 1407 ALLEN DR STE I
Second Line :
City : TROY
State : MI
Zip : 48083-4009
Country : US
Telephone Number : 248-971-0420
Fax Number : 248-780-3786
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2019
Last Update Date : 05/29/2026

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