Healthcare Provider Details

I. General information

NPI: 1780762823
Provider Name (Legal Business Name): FARAH ANEES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 09/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4009 LOUISA ROAD
CATLETTSBURG KY
41129
US

IV. Provider business mailing address

13 SENECA RD
HUNTINGTON WV
25705-4125
US

V. Phone/Fax

Practice location:
  • Phone: 606-739-3095
  • Fax:
Mailing address:
  • Phone: 304-521-2987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE4816
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR3468
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: