Provider Demographics
NPI:1275620171
Name:KARIMIPOUR, DARIUS JAMES (MD)
Entity Type:Individual
Prefix:
First Name:DARIUS
Middle Name:JAMES
Last Name:KARIMIPOUR
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 1:43700 WOODWARD AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-5058
Mailing Address - Country:US
Mailing Address - Phone:248-332-0103
Mailing Address - Fax:248-332-1070
Practice Address - Street 1:43700 WOODWARD AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-5058
Practice Address - Country:US
Practice Address - Phone:248-332-0103
Practice Address - Fax:248-332-1070
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301070080207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4230279Medicaid
MIH20118Medicare UPIN
MI4230279Medicaid