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General NPI Number Information
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NPI Number | 1700345667
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Entity Type | Individual
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Provider Name | ADNAN MUHAMMAD IBNA FARUQUI MD
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Gender | Male
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Dates
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Enumeration Date | 03/19/2019
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 2501 GREENWOOD RD
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City | SHREVEPORT
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State | LA
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Zip | 71103-3905
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Country | US
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Telephone | 318-631-1584
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Fax | 318-635-8322
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Provider Business Mailing Address
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Address Line | 1800 BUCKNER ST STE C120
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City | SHREVEPORT
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State | LA
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Zip | 71101-4453
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Country | US
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Telephone | 318-213-2761
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Fax | 318-681-8047
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 348374
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License Number State | LA
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