Provider Demographics
NPI:1659674174
Name:SARIH DALATI MD, PC
Entity Type:Organization
Organization Name:SARIH DALATI MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARIH
Authorized Official - Middle Name:
Authorized Official - Last Name:DALATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-773-9950
Mailing Address - Street 1:PO BOX 250974
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48325-0974
Mailing Address - Country:US
Mailing Address - Phone:586-773-9950
Mailing Address - Fax:586-773-9970
Practice Address - Street 1:22850 KELLY RD STE C
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-2028
Practice Address - Country:US
Practice Address - Phone:586-773-9950
Practice Address - Fax:586-773-9970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI373159251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management