Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 5901002750 | MI |
NPI | 1073008371 |
---|---|
Provider Name | Firras Garada |
First Address | Oak Park, MI 48237-1726 |
Second Address | Warren, MI 48091-2279 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2018 |
Last Update Date | 28/06/2018 |