Provider Demographics
NPI:1194985689
Name:STEVEN J. FADOIR, PH.D. P.C.
Entity type:Organization
Organization Name:STEVEN J. FADOIR, PH.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:FADOIR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-737-9903
Mailing Address - Street 1:31330 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE D
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2560
Mailing Address - Country:US
Mailing Address - Phone:248-737-9903
Mailing Address - Fax:248-737-9963
Practice Address - Street 1:31330 NORTHWESTERN HWY
Practice Address - Street 2:SUITE D
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2560
Practice Address - Country:US
Practice Address - Phone:248-737-9903
Practice Address - Fax:248-737-9963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006008261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center