Sholeh Vaziri, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

SV071408 Issued in MI

Practice address

6770 Dixie Hwy
Suite 200
Clarkston, MI 48346-2087

Phone

(248) 625-2621

Fax

(248) 625-8938

NPI assigned

Jul 14, 2005

Last updated

Aug 30, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314662400000",
    "number": "1932107794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6770 DIXIE HWY",
            "address_2": "SUITE 200",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462087",
            "telephone_number": "248-625-2621",
            "fax_number": "248-625-8938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6770 DIXIE HWY",
            "address_2": "SUITE 200",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462087",
            "telephone_number": "248-625-2621",
            "fax_number": "248-625-8938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZIRI",
        "first_name": "SHOLEH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-14",
        "last_updated": "2011-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "SV071408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IND",
            "identifier": "1106332741",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932107794",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE IND PIN",
            "identifier": "P00943708",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Hope Frances Verville, BEHAVIOR TECHNICIAN
• Lauren Victor, MSW
• Emily L Vierik, BEHAVIOR TECHNICIAN

• Internal Medicine Physician in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; 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.