Provider Demographics
NPI:1407378714
Name:IRFAN, HIRA
Entity type:Individual
Prefix:
First Name:HIRA
Middle Name:
Last Name:IRFAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29275 W 10 MILE RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-2817
Mailing Address - Country:US
Mailing Address - Phone:248-350-2722
Mailing Address - Fax:248-350-0154
Practice Address - Street 1:3125 CHAD DR STE 100
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97408-7440
Practice Address - Country:US
Practice Address - Phone:541-687-1712
Practice Address - Fax:541-687-7943
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD222885207RP1001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program