Provider Demographics
NPI:1669703781
Name:FARHAT, MIRNA (MD)
Entity type:Individual
Prefix:DR
First Name:MIRNA
Middle Name:
Last Name:FARHAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:26672 DOXTATOR ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-3334
Mailing Address - Country:US
Mailing Address - Phone:313-789-7189
Mailing Address - Fax:313-789-7188
Practice Address - Street 1:1537 MONROE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124
Practice Address - Country:US
Practice Address - Phone:313-789-7189
Practice Address - Fax:313-789-7188
Is Sole Proprietor?:No
Enumeration Date:2010-01-29
Last Update Date:2019-02-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301089788207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology