Healthcare Provider Details

I. General information

NPI: 1356093785
Provider Name (Legal Business Name): HUMAID AL FARII
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2022
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 ORLEANS ST
BALTIMORE MD
21287-0010
US

IV. Provider business mailing address

414 LIGHT ST UNIT 4106
BALTIMORE MD
21202-1346
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-8344
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberD0092092
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: