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NPI Code Detail

MEDICARE: FARAHABA LAKHDIR MD

MEDICARE: FARAHABA LAKHDIR 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
1208000000XPediatrics Physician0101-237034VA
22080P0210XPediatric Nephrology Physician0101-237034VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922087279
Entity Type Code : Individual
Provider Name (Legal Business Name) : FARAHABA LAKHDIR MD
Provider Business Mailing Address
First Line : 5827 CHAGALL CIR
Second Line :
City : ROANOKE
State : VA
Zip : 24018-5276
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4348 ELECTRIC RD
Second Line :
City : ROANOKE
State : VA
Zip : 24018-0720
Country : US
Telephone Number : 540-769-0976
Fax Number : 540-857-5391
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2006
Last Update Date : 11/02/2021

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Directions to “ FARAHABA LAKHDIR MD” Practice Location

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