Provider Demographics
NPI:1124271978
Name:ALQARA, FARES (MD)
Entity type:Individual
Prefix:
First Name:FARES
Middle Name:
Last Name:ALQARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4685 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3397
Mailing Address - Country:US
Mailing Address - Phone:513-853-4721
Mailing Address - Fax:
Practice Address - Street 1:7700 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2505
Practice Address - Country:US
Practice Address - Phone:513-475-8248
Practice Address - Fax:513-475-8468
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.096199207V00000X
IL036-136355207V00000X
IN01074346B207V00000X
KY53177207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty