MEDICARE: DR. IBRAHIM FARAH MS, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247ZC0005X	Clinical Laboratory Director (Non-physician)
2	246QL0900X	Laboratory Management Specialist/Technologist

General Provider Information

NPI Number	:	1083234868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IBRAHIM FARAH MS, PHD

Provider Business Mailing Address
First Line	:	1426 GELBRAY AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-1881
Country	:	US
Telephone Number	:	614-664-9201
Fax Number	:

Provider Business Practice Location Address
First Line	:	1426 GELBRAY AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-1881
Country	:	US
Telephone Number	:	614-664-9201
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2020
Last Update Date	:	12/18/2025

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