Active NPI
Mahtab Darvish, MD
- Student in an Organized Health Care Education/Training Program
- Ann Arbor, MI
National Provider Identifier
1740082288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 325 E Eisenhower Pkwy Ste 200
Ann Arbor, MI 48108-3346 - Phone
- (734) 936-7175
- NPI assigned
- Mar 25, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
325 E Eisenhower Pkwy Ste 200
Ann Arbor, MI 48108-3346
Mailing address
1238 Horseshoe Cir Apt 201
Ann Arbor, MI 48108-2423
Phone (443) 362-9970
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250606000696 | GA | Order and Referring Only - Internal Medicine | 5799295093 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17231 | GA | MD | Medical Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783555200000",
"number": "1740082288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1238 HORSESHOE CIR APT 201",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481082423",
"telephone_number": "443-362-9970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 E EISENHOWER PKWY STE 200",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481083346",
"telephone_number": "734-936-7175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DARVISH",
"first_name": "MAHTAB",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-25",
"last_updated": "2026-07-09",
"certification_date": "2026-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.