Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 2901019512 | MI |
N | 204E00000X | Oral & Maxillofacial Surgeon | 4301106347 | MI |
N | 208200000X | Surgeon | 4301106347 | MI |
N | 208600000X | Surgeon | 4301106347 | MI |
NPI | 1215192745 |
---|---|
Provider Name | Dr. Frank Farbod, M.d., D.m.d |
First Address | Marquette, MI 49855-0171 |
Second Address | Marquette, MI 49855-2680 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2008 |
Last Update Date | 08/09/2020 |