Basic Information
Provider Information
NPI: 1265819171
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SILEVANY
FirstName: FARASHIN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1215 E MICHIGAN AVE
Address2:  
City: LANSING
State: MI
PostalCode: 489121811
CountryCode: US
TelephoneNumber: 5173641000
FaxNumber:  
Practice Location
Address1: 1200 E MICHIGAN AVE
Address2:  
City: LANSING
State: MI
PostalCode: 489121800
CountryCode: US
TelephoneNumber: 5173641000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/29/2015
LastUpdateDate: 02/10/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/10/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X5101021575MIY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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