Organization
MICHIGAN HEMATOLOGY ONCOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARID T FATA M.D. (PRESIDENT)
(248) 844-5690
Entity
Organization
Contact information
Practice address
1901 STAR BATT DR, SUITE 200, ROCHESTER HILLS, MI 48309-3712
(248) 844-5690
(248) 844-5691
Mailing address
1901 STAR BATT DR, SUITE 200, ROCHESTER HILLS, MI 48309-3712
(248) 844-5690
(248) 844-5691
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
6801084651
MI
1041C0700X
Clinical Social Worker
6801089528
MI
207RH0003X
Hematology & Oncology Physician
Primary
4301072629
MI
207RH0003X
Hematology & Oncology Physician
4301082244
MI
207RH0003X
Hematology & Oncology Physician
5101017226
MI
363A00000X
Physician Assistant
5601005949
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F35662
BCBSM GROUP PIN
MI
01
—
0F39539
BCBSM GROUP PIN FOR SOCIAL WORKERS
MI
05
—
104732771
—
MI
Enumeration date
01/26/2007
Last updated
07/05/2011
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