MEDICARE: RICHARD F FARAH MD PC

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
1	208600000X	Surgery Physician	2483	AK

General Provider Information

NPI Number	:	1891942637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD F FARAH MD PC

Provider Business Mailing Address
First Line	:	4141 B ST
Second Line	:	SUITE 401
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-5940
Country	:	US
Telephone Number	:	907-770-2301
Fax Number	:	907-770-2325

Provider Business Practice Location Address
First Line	:	4141 B ST
Second Line	:	SUITE 401
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-5940
Country	:	US
Telephone Number	:	907-770-2301
Fax Number	:	907-770-2325

Authorized Official
Title or Position	:	OWNER / PRES
Name	:	RICHARD F FARAH
Credential	:	M.D.
Telephone Number	:	907-770-2301

Provider Enumeration Date	:	08/22/2008
Last Update Date	:	08/22/2008

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