Provider Demographics
NPI:1194876623
Name:SAROSH, ADIL (DC)
Entity type:Individual
Prefix:DR
First Name:ADIL
Middle Name:
Last Name:SAROSH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:CARLETON
Mailing Address - State:MI
Mailing Address - Zip Code:48117-9382
Mailing Address - Country:US
Mailing Address - Phone:734-654-3730
Mailing Address - Fax:
Practice Address - Street 1:1127 MONROE ST
Practice Address - Street 2:
Practice Address - City:CARLETON
Practice Address - State:MI
Practice Address - Zip Code:48117-9382
Practice Address - Country:US
Practice Address - Phone:734-654-3730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950E85236OtherBCBSM
MI950E85236OtherBCBSM