Provider Demographics
NPI:1730382086
Name:AHMEDI, FARHAT S (MD)
Entity type:Individual
Prefix:
First Name:FARHAT
Middle Name:S
Last Name:AHMEDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FARHAT
Other - Middle Name:S
Other - Last Name:SHAIKH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1437 W AUTO DR STE 108
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-1016
Mailing Address - Country:US
Mailing Address - Phone:480-362-2983
Mailing Address - Fax:855-889-8024
Practice Address - Street 1:1437 W AUTO DR STE 108
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-1016
Practice Address - Country:US
Practice Address - Phone:480-362-2983
Practice Address - Fax:855-889-8024
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57009266207R00000X
NJ25MA08725800207R00000X
AZ41108207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ387103Medicaid
AZ387103Medicaid