Provider Demographics
NPI:1649213463
Name:FARAJ, DAOUD ABBAS (MD)
Entity Type:Individual
Prefix:DR
First Name:DAOUD
Middle Name:ABBAS
Last Name:FARAJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:13530 MICHIGAN AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-3555
Mailing Address - Country:US
Mailing Address - Phone:313-908-9004
Mailing Address - Fax:313-908-7873
Practice Address - Street 1:13530 MICHIGAN AVE STE 300
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-3555
Practice Address - Country:US
Practice Address - Phone:313-908-9004
Practice Address - Fax:313-908-7873
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2019-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI207Q00000X207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI10 4706145 0Medicaid
MII26588Medicare UPIN
MI10 4706145 0Medicaid