Healthcare Provider Details

I. General information

NPI: 1952364366
Provider Name (Legal Business Name): NAGUIB HANI HANNA FARAH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: NAGUIB H. FARAH MD

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 05/10/2022
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MORVEN RD
WADESBORO NC
28170-2745
US

IV. Provider business mailing address

200 CORPORATE BLVD
LAFAYETTE LA
70508-3870
US

V. Phone/Fax

Practice location:
  • Phone: 800-893-9698
  • Fax:
Mailing address:
  • Phone: 800-893-9698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101268923
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9401403
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: