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General NPI Number Information
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NPI Number | 1346734050
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Entity Type | Individual
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Provider Name | FARAH AHMED DO
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Gender | Female
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Dates
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Enumeration Date | 06/15/2018
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Last Update Date | 03/17/2022
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Provider Practice Location Address
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Address Line | 718 N MACOMB ST
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City | MONROE
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State | MI
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Zip | 48162-7815
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Country | US
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Telephone | 734-240-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 3445 N CENTRAL AVE
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City | CHICAGO
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State | IL
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Zip | 60634-4420
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Country | US
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Telephone | 773-205-0800
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Fax | 773-205-1804
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036153883
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License Number State | IL
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