Provider Demographics
NPI:1770635666
Name:FAMILY HEALTH & PREVENTION PC INC
Entity Type:Organization
Organization Name:FAMILY HEALTH & PREVENTION PC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SOHRAB
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAFINIA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-225-4244
Mailing Address - Street 1:7655 HIGHLAND RD STE 202
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-1485
Mailing Address - Country:US
Mailing Address - Phone:248-225-4244
Mailing Address - Fax:888-704-0304
Practice Address - Street 1:30275 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-5602
Practice Address - Country:US
Practice Address - Phone:248-225-4244
Practice Address - Fax:888-704-0304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISS012201207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty