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General NPI Number Information
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NPI Number | 1821093923
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Entity Type | Individual
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Provider Name | SEFERINO FARIAS MD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2005
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Last Update Date | 04/02/2021
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Provider Practice Location Address
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Address Line | 12800 MISSISSIPPI PKWY STE C101
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City | CROWN POINT
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State | IN
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Zip | 46307-6901
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Country | US
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Telephone | 219-661-0444
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Fax | 219-226-1222
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Provider Business Mailing Address
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Address Line | 1040 SIERRA DR STE 400
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City | GREENWOOD
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State | IN
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Zip | 46143-7241
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Country | US
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Telephone | 317-528-4800
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 01053482A
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License Number State | IN
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