Healthcare Provider Details

I. General information

NPI: 1558795963
Provider Name (Legal Business Name): DR. FARHAN ABDI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2013
Last Update Date: 08/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 N ROCK RD APT#1308
WICHITA KS
67206-1743
US

IV. Provider business mailing address

505 N ROCK RD APT#1308
WICHITA KS
67206-1743
US

V. Phone/Fax

Practice location:
  • Phone: 614-599-5091
  • Fax:
Mailing address:
  • Phone: 614-599-5091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number1-16117
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: