Provider Demographics
NPI:1164623823
Name:BAKHTYAR, ARSALA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARSALA
Middle Name:
Last Name:BAKHTYAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1863
Mailing Address - Fax:947-522-0307
Practice Address - Street 1:18181 OAKWOOD BLVD STE 401
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-5031
Practice Address - Country:US
Practice Address - Phone:313-593-7240
Practice Address - Fax:313-593-8899
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2023-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010895892080P0208X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases