Healthcare Provider Details

I. General information

NPI: 1023009743
Provider Name (Legal Business Name): FARRUKH R SHEIKH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 12/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7247 W CENTRAL AVE SUITE A
TOLEDO OH
43617-1177
US

IV. Provider business mailing address

7247 W CENTRAL AVE SUITE A
TOLEDO OH
43617-1177
US

V. Phone/Fax

Practice location:
  • Phone: 419-843-8815
  • Fax: 419-843-8816
Mailing address:
  • Phone: 419-843-8815
  • Fax: 419-843-8816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number48043
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number090872
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number4301091187
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: