Provider Demographics
NPI:1164648473
Name:IBIN SINA CENTER FOR CARDIAC & VASCULAR DISEASE PLLC
Entity Type:Organization
Organization Name:IBIN SINA CENTER FOR CARDIAC & VASCULAR DISEASE PLLC
Other - Org Name:FARID FARAJ ZAYED MD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARID
Authorized Official - Middle Name:FARAJ
Authorized Official - Last Name:ZAYED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-945-0505
Mailing Address - Street 1:20225 ANN ARBOR TRL
Mailing Address - Street 2:SUITE A
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2690
Mailing Address - Country:US
Mailing Address - Phone:313-529-3939
Mailing Address - Fax:888-828-7361
Practice Address - Street 1:20225 ANN ARBOR TRL
Practice Address - Street 2:SUITE A
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-2690
Practice Address - Country:US
Practice Address - Phone:313-529-3939
Practice Address - Fax:888-828-7361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301060425207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4782227Medicaid
MI024154OtherMIDWEST MEDICAID
MI1108235471OtherBCBS
FM0P45590Medicare PIN
MI4782227Medicaid