Provider Demographics
NPI:1275691933
Name:FAIRVIEW GROUP, INC.
Entity Type:Organization
Organization Name:FAIRVIEW GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-OWNER
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:313-581-3000
Mailing Address - Street 1:5245 SCHAEFER RD
Mailing Address - Street 2:STE A
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126
Mailing Address - Country:US
Mailing Address - Phone:313-581-3000
Mailing Address - Fax:313-581-6464
Practice Address - Street 1:5245 SCHAEFER RD
Practice Address - Street 2:STE A
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-3257
Practice Address - Country:US
Practice Address - Phone:313-581-3000
Practice Address - Fax:313-581-6464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010560382085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4763061Medicaid
MI0P21320Medicare ID - Type UnspecifiedMEDICARE ID