Provider Demographics
NPI:1427413400
Name:SALAR, NOORHAN
Entity Type:Individual
Prefix:
First Name:NOORHAN
Middle Name:
Last Name:SALAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 W ANN ARBOR TRL
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1502
Mailing Address - Country:US
Mailing Address - Phone:734-667-5152
Mailing Address - Fax:734-667-2579
Practice Address - Street 1:30488 MILFORD RD
Practice Address - Street 2:
Practice Address - City:NEW HUDSON
Practice Address - State:MI
Practice Address - Zip Code:48165-8583
Practice Address - Country:US
Practice Address - Phone:248-437-4625
Practice Address - Fax:248-437-4665
Is Sole Proprietor?:No
Enumeration Date:2015-12-17
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
MI5601010160363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other