Provider Demographics
NPI:1750340576
Name:SALAHI, FAROUK (MD)
Entity type:Individual
Prefix:
First Name:FAROUK
Middle Name:
Last Name:SALAHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:67200 VAN DYKE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WASHINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48095-1463
Mailing Address - Country:US
Mailing Address - Phone:586-752-9895
Mailing Address - Fax:586-752-0740
Practice Address - Street 1:2708 S ROCHESTER RD
Practice Address - Street 2:SUITE B
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-4577
Practice Address - Country:US
Practice Address - Phone:248-852-0797
Practice Address - Fax:586-752-0740
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301051155207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0636090OtherBCN
MI105202457Medicaid
MI0636090OtherBCBS
MIE25878OtherHAP
MIE25878Medicare UPIN
MI105202457Medicaid