Provider Demographics
NPI:1487638987
Name:BABAOFF, ABRAHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:
Last Name:BABAOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EBRAHIM
Other - Middle Name:
Other - Last Name:BABAOFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:28555 ORCHARD LAKE RD
Mailing Address - Street 2:STE 120
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334
Mailing Address - Country:US
Mailing Address - Phone:248-489-1070
Mailing Address - Fax:248-489-0850
Practice Address - Street 1:28555 ORCHARD LAKE RD
Practice Address - Street 2:STE 120
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2973
Practice Address - Country:US
Practice Address - Phone:248-489-1070
Practice Address - Fax:248-489-0850
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301032956207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4133346Medicaid
MIM85190002Medicare ID - Type Unspecified
B43683Medicare UPIN