Michigan Hematology Oncology, PC

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

FF072629 Issued in MI

Legal business name

MICHIGAN HEMATOLOGY ONCOLOGY, PC

Practice address

5680 Bow Pointe Dr
Ste 201
Clarkston, MI 48346-5407

Phone

(248) 620-9600

Fax

(248) 620-9677

NPI assigned

Jun 3, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Farid T Fata, MD

Title

President

Phone

(248) 620-9600

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292457600000",
    "number": "1750601456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5680 BOW POINTE DR",
            "address_2": "STE 201",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483465407",
            "telephone_number": "248-620-9600",
            "fax_number": "248-620-9677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5680 BOW POINTE DR",
            "address_2": "STE 201",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483465407",
            "telephone_number": "248-620-9600",
            "fax_number": "248-620-9677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN HEMATOLOGY ONCOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-03",
        "last_updated": "2010-12-16",
        "status": "A",
        "authorized_official_last_name": "FATA",
        "authorized_official_first_name": "FARID",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-620-9600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "FF072629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104732771",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Hematology & Oncology Physician in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Hematology & Oncology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.