Provider Demographics
NPI:1003921891
Name:KIARASH, ARASH (MD, MS)
Entity Type:Individual
Prefix:MR
First Name:ARASH
Middle Name:
Last Name:KIARASH
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25500 GODDARD RD.
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180
Mailing Address - Country:US
Mailing Address - Phone:313-914-2395
Mailing Address - Fax:313-914-2437
Practice Address - Street 1:25500 GODDARD RD.
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180
Practice Address - Country:US
Practice Address - Phone:313-914-2395
Practice Address - Fax:313-914-2437
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301081959207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine