Provider Demographics
NPI:1386603587
Name:FARID, FARID (MD)
Entity type:Individual
Prefix:
First Name:FARID
Middle Name:
Last Name:FARID
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 1:880 SEVEN HILLS DR
Mailing Address - Street 2:SUITE 160
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4371
Mailing Address - Country:US
Mailing Address - Phone:702-914-6050
Mailing Address - Fax:702-914-6115
Practice Address - Street 1:880 SEVEN HILLS DR
Practice Address - Street 2:SUITE 160
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4371
Practice Address - Country:US
Practice Address - Phone:702-914-6050
Practice Address - Fax:702-914-6115
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8181207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G68842Medicare UPIN