Provider Demographics
NPI:1679529978
Name:DRS. HARRIS, BIRKHILL, WANG, SONGE AND ASSOCIATES, P.C
Entity Type:Organization
Organization Name:DRS. HARRIS, BIRKHILL, WANG, SONGE AND ASSOCIATES, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:R
Authorized Official - Last Name:FARAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-359-7645
Mailing Address - Street 1:840 OAKWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2319
Mailing Address - Country:US
Mailing Address - Phone:313-359-7600
Mailing Address - Fax:313-359-7678
Practice Address - Street 1:840 OAKWOOD BLVD.
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124
Practice Address - Country:US
Practice Address - Phone:313-359-7600
Practice Address - Fax:313-359-7678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH276050OtherBLUE SHIELD
MIN/AMedicaid
OH276050OtherBLUE SHIELD
MI0H26272Medicare PIN
MI0H26274Medicare PIN
MIOP56680Medicare PIN