Healthcare Provider Details

I. General information

NPI: 1932738598
Provider Name (Legal Business Name): FARIDOON WAHID MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 ELM ST NE
ALBUQUERQUE NM
87102-2512
US

IV. Provider business mailing address

4777 E GALBRAITH RD
CINCINNATI OH
45236-2725
US

V. Phone/Fax

Practice location:
  • Phone: 505-727-8360
  • Fax:
Mailing address:
  • Phone: 513-686-5446
  • Fax: 513-686-6868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.147977
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD2025-0132
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: