Provider Demographics
NPI:1194713875
Name:DARWISH, DARWISH O (MD)
Entity type:Individual
Prefix:
First Name:DARWISH
Middle Name:O
Last Name:DARWISH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19925 VERNIER RD
Mailing Address - Street 2:
Mailing Address - City:HARPER WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48225-1486
Mailing Address - Country:US
Mailing Address - Phone:313-245-1400
Mailing Address - Fax:313-245-1492
Practice Address - Street 1:19925 VERNIER RD
Practice Address - Street 2:
Practice Address - City:HARPER WOODS
Practice Address - State:MI
Practice Address - Zip Code:48225-1486
Practice Address - Country:US
Practice Address - Phone:313-245-1400
Practice Address - Fax:313-245-1492
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301059173207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700E012740OtherBCBSM GROUP NUMBER
MI700H249730OtherBCBSM GROUP NUMBER
MI4563383Medicaid
MIG11477Medicare UPIN
MI4563383Medicaid
MI0N40170Medicare PIN
MI700E012740OtherBCBSM GROUP NUMBER