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NPI Code Detail

MEDICARE: DR. SAMIR CYRUS FARUQUE MD

MEDICARE: DR. SAMIR CYRUS FARUQUE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician11025186AIN

General Provider Information

NPI Number : 1437827631
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMIR CYRUS FARUQUE MD
Provider Business Mailing Address
First Line : 2200 RANDALLIA DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-4638
Country : US
Telephone Number : 260-373-7765
Fax Number : 260-373-7760
Provider Business Practice Location Address
First Line : 2231 CAREW ST
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-4713
Country : US
Telephone Number : 260-373-7765
Fax Number : 260-373-7770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2021
Last Update Date : 06/25/2026

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