Provider Demographics
NPI:1790941805
Name:DAYHIM, FARIBA (MD)
Entity Type:Individual
Prefix:
First Name:FARIBA
Middle Name:
Last Name:DAYHIM
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 1:7459 MIDDLEBELT RD STE 3
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-4184
Mailing Address - Country:US
Mailing Address - Phone:482-763-3554
Mailing Address - Fax:
Practice Address - Street 1:455 TOLL GATE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2759
Practice Address - Country:US
Practice Address - Phone:401-737-7010
Practice Address - Fax:401-738-0013
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9248208600000X
MEMD18264208600000X
MI4301116561208600000X
RIMD17873208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BN480OtherBC/BS
TX196744001Medicaid
8L2411Medicare PIN