Provider Demographics
NPI:1801053996
Name:FALLAHI, AMIR-KIANOOSH M (MD)
Entity type:Individual
Prefix:DR
First Name:AMIR-KIANOOSH
Middle Name:M
Last Name:FALLAHI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14555 LEVAN RD
Mailing Address - Street 2:SUITE 116
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-5083
Mailing Address - Country:US
Mailing Address - Phone:734-464-0400
Mailing Address - Fax:734-464-0404
Practice Address - Street 1:14555 LEVAN RD
Practice Address - Street 2:SUITE 116
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-5083
Practice Address - Country:US
Practice Address - Phone:734-464-0400
Practice Address - Fax:734-464-0404
Is Sole Proprietor?:No
Enumeration Date:2008-05-17
Last Update Date:2014-06-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL125051909207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery