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Payaum Fotovat-ahmadi
Student in an Organized Health Care Education/Training Program in Lathrup Village, Michigan
NPI 1225715683

Payaum Fotovat-ahmadi is a Student in an Organized Health Care Education/Training Program based in Lathrup Village, MI. Payaum Fotovat-ahmadi practices in Lathrup Village, MI. The NPI Number for Payaum Fotovat-ahmadi is 1225715683 and holds a License No. (Michigan).

The current practice location address for Payaum Fotovat-ahmadi is 27270 Evergreen Rd, Lathrup Village, MI and can be reached out via phone at 734-812-0429.

Location: 27270 Evergreen Rd, Lathrup Village, MI, 48076-3249
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1225715683
Provider Name
Payaum Fotovat-ahmadi
Credential
Provider Entity Type
Individual
Gender
Male
Address
27270 Evergreen Rd, Lathrup Village, MI, 48076-3249
Phone Number
734-812-0429
Fax Number
Provider Enumeration Date
06/28/2023
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
F313676025878 01 MI LICENSE NUMBER
institution
Provider Business Practice Location Address Details
Address
27270 Evergreen Rd
City
Lathrup Village
State
Michigan
Zip
48076-3249
Phone Number
734-812-0429
Fax Number
person
Provider Business Mailing Address Details
Address
27270 Evergreen Rd
City
Lathrup Village
State
Michigan
Zip
48076-3249
Phone Number
734-812-0429
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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