Provider Demographics
NPI:1508993882
Name:ABHARI, FARNAZ (MD)
Entity Type:Individual
Prefix:
First Name:FARNAZ
Middle Name:
Last Name:ABHARI
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 1:3287 WARDS POINT DR
Mailing Address - Street 2:
Mailing Address - City:ORCHARD LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48324-1652
Mailing Address - Country:US
Mailing Address - Phone:248-231-8369
Mailing Address - Fax:248-489-9076
Practice Address - Street 1:33110 W 12 MILE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3307
Practice Address - Country:US
Practice Address - Phone:248-855-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301065718207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4358551Medicaid
MI4358551Medicaid
G39401Medicare UPIN