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NPI Code Detail

MEDICARE: FARAH IMAD

MEDICARE:   FARAH  IMAD
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
11041C0700XClinical Social Worker6801093019MI

General Provider Information

NPI Number : 1770912446
Entity Type Code : Individual
Provider Name (Legal Business Name) : FARAH IMAD
Provider Business Mailing Address
First Line : 6451 SCHAEFER RD
Second Line :
City : DEARBORN
State : MI
Zip : 48126-2212
Country : US
Telephone Number : 313-945-8138
Fax Number : 313-624-9418
Provider Business Practice Location Address
First Line : 6451 SCHAEFER RD
Second Line :
City : DEARBORN
State : MI
Zip : 48126-2212
Country : US
Telephone Number : 313-945-8138
Fax Number : 313-624-9418
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2013
Last Update Date : 11/04/2013

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Directions to “ FARAH IMAD ” Practice Location

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