Provider Demographics
NPI:1376040360
Name:ORANDI ALLERGY AND ASTHMA CENTER PLLC
Entity Type:Organization
Organization Name:ORANDI ALLERGY AND ASTHMA CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARIUSH
Authorized Official - Middle Name:J
Authorized Official - Last Name:ORANDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-794-6301
Mailing Address - Street 1:PO BOX 3140
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49501-3140
Mailing Address - Country:US
Mailing Address - Phone:616-459-6867
Mailing Address - Fax:616-726-1180
Practice Address - Street 1:2221 HEALTH DR SW STE 1400
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519
Practice Address - Country:US
Practice Address - Phone:616-794-6301
Practice Address - Fax:616-504-1702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-07
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301095171207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty