Healthcare Provider Details

I. General information

NPI: 1073435038
Provider Name (Legal Business Name): HAJRA FAROOQ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E ROSSER AVE
BISMARCK ND
58501-4461
US

IV. Provider business mailing address

701 E ROSSER AVE
BISMARCK ND
58501-4461
US

V. Phone/Fax

Practice location:
  • Phone: 701-751-9500
  • Fax: 701-751-9508
Mailing address:
  • Phone: 701-751-9500
  • Fax: 701-751-9508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRL24414
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: