MEDICARE: WALID A FARHAT MD

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	2088P0231X	Pediatric Urology Physician	71234	WI

General Provider Information

NPI Number	:	1861052441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WALID A FARHAT MD

Provider Business Mailing Address
First Line	:	3316 BLACKHAWK DR
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53705-1402
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3316 BLACKHAWK DR
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53705-1402
Country	:	US
Telephone Number	:	608-628-6336
Fax Number	:

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

Provider Enumeration Date	:	06/17/2019
Last Update Date	:	12/18/2025

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