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General NPI Number Information
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NPI Number | 1831448497
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Entity Type | Organization
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Legal Business Name | AZMI FARAG, MD, P.C.
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Dates
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Enumeration Date | 08/29/2012
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Last Update Date | 08/29/2012
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Provider Practice Location Address
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Address Line | 5390 N ACADEMY BLVD SUITE 220
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918
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Country | US
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Telephone | 719-268-9000
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Fax | 719-268-6687
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Provider Business Mailing Address
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Address Line | 5390 N ACADEMY BLVD SUITE 220
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918
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Country | US
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Telephone | 719-268-9000
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Fax | 719-268-6687
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AZMI E FARAG
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Credential | M.D.
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Telephone | 719-268-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 30594
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License Number State | CO
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