Provider Demographics
NPI:1225006802
Name:JOORABCHI, BAHMAN B (MD)
Entity Type:Individual
Prefix:DR
First Name:BAHMAN
Middle Name:B
Last Name:JOORABCHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43380 WOODWARD AVE
Mailing Address - Street 2:STE 105
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302
Mailing Address - Country:US
Mailing Address - Phone:248-335-8500
Mailing Address - Fax:248-335-5430
Practice Address - Street 1:43380 WOODWARD AVE
Practice Address - Street 2:STE 105
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302
Practice Address - Country:US
Practice Address - Phone:248-335-8500
Practice Address - Fax:248-335-5430
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010452012080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2686722Medicaid
B44596Medicare UPIN
MI2686722Medicaid