Basic Information
| Provider Information | |||||||||
| NPI: | 1639510662 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TARRAR | ||||||||
| FirstName: | IMRAN HAYAT | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 44405 WOODWARD AVE | ||||||||
| Address2: | ST. JOSEPH MERCY OAKLAND, MEDICAL EDUCATION DEPTT. | ||||||||
| City: | PONTIAC | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483415023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488586233 | ||||||||
| FaxNumber: | 2488583294 | ||||||||
| Practice Location | |||||||||
| Address1: | 44405 WOODWARD AVE | ||||||||
| Address2: | ST. JOSEPH MERCY OAKLAND, MEDICAL EDUCATION DEPTT. | ||||||||
| City: | PONTIAC | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483415023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488586233 | ||||||||
| FaxNumber: | 2488583294 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2013 | ||||||||
| LastUpdateDate: | 07/06/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4301102785 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.