Provider Demographics
NPI:1740779826
Name:DANESHVAR, FARZAD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:FARZAD
Middle Name:
Last Name:DANESHVAR
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5941 SHAUN RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-1627
Mailing Address - Country:US
Mailing Address - Phone:248-910-2222
Mailing Address - Fax:
Practice Address - Street 1:24725 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-4500
Practice Address - Country:US
Practice Address - Phone:586-651-5306
Practice Address - Fax:586-447-3636
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-04
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020395431835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist