Basic Information
Provider Information
NPI: 1417010372
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SOLEIMANPOUR
FirstName: ARASH
MiddleName: SCOTT
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SOLEIMANPOUR
OtherFirstName: ARASH
OtherMiddleName: SCOTT
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 2
Mailing Information
Address1: 3621 S STATE ST
Address2:  
City: ANN ARBOR
State: MI
PostalCode: 481081633
CountryCode: US
TelephoneNumber: 7346475299
FaxNumber:  
Practice Location
Address1: 24 FRANK LLOYD WRIGHT DR
Address2: LOBBY C SUITE 1300
City: ANN ARBOR
State: MI
PostalCode: 481059484
CountryCode: US
TelephoneNumber: 7346475871
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/19/2006
LastUpdateDate: 06/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X4301104653MIN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RE0101XMT184083PAN Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
207RE0101XMD433532PAN Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
207RE0101X4301104653MIY Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism

No ID Information.


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