=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396323978
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SAHIRA FAROOQ
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/01/2021
-----------------------------------------------------
Last Update Date | 12/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3231 GLACIER HWY
-----------------------------------------------------
City | JUNEAU
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99801-7842
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-463-0220
-----------------------------------------------------
Fax | 907-463-0221
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3100 CHANNEL DR STE 300
-----------------------------------------------------
City | JUNEAU
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99801-7837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-463-4074
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207N00000X
-----------------------------------------------------
Taxonomy Name | Dermatology Physician
-----------------------------------------------------
License Number | 242935
-----------------------------------------------------
License Number State | AK
-----------------------------------------------------