Healthcare Provider Details

I. General information

NPI: 1063830016
Provider Name (Legal Business Name): FARHAN HUQ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2014
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 NEW HOLLAND AVE STE A
LANCASTER PA
17602-2179
US

IV. Provider business mailing address

258 BEN FRANKLIN HWY E
BIRDSBORO PA
19508-8772
US

V. Phone/Fax

Practice location:
  • Phone: 717-431-7546
  • Fax:
Mailing address:
  • Phone: 610-288-2908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number4301105082
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD479758
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberMD479758
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: