Provider Demographics
NPI:1275984239
Name:ADIBI, FARNAZ (MD)
Entity Type:Individual
Prefix:DR
First Name:FARNAZ
Middle Name:
Last Name:ADIBI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 S CANTON CENTER RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-1992
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 S CANTON CENTER RD
Practice Address - Street 2:SUITE 220
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-1992
Practice Address - Country:US
Practice Address - Phone:734-398-8790
Practice Address - Fax:734-398-8680
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program