Provider Demographics
NPI:1669730008
Name:DARRAH, CASEY (MD)
Entity type:Individual
Prefix:DR
First Name:CASEY
Middle Name:
Last Name:DARRAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34740 W 8 MILE RD APT 1
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-5111
Mailing Address - Country:US
Mailing Address - Phone:419-346-3043
Mailing Address - Fax:
Practice Address - Street 1:24371 W 10 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-2929
Practice Address - Country:US
Practice Address - Phone:248-809-6088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH127592208D00000X
MI4301101902208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice