Provider Demographics
NPI:1023360971
Name:FRANK M FAYZ MD PC
Entity Type:Organization
Organization Name:FRANK M FAYZ MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:M
Authorized Official - Last Name:FAYZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-680-2173
Mailing Address - Street 1:600 TOWN CENTER DR
Mailing Address - Street 2:SUITE 1275
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2718
Mailing Address - Country:US
Mailing Address - Phone:313-680-2173
Mailing Address - Fax:
Practice Address - Street 1:600 TOWN CENTER DR
Practice Address - Street 2:SUITE 1275
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2718
Practice Address - Country:US
Practice Address - Phone:313-680-2173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010560382085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty