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Organization
HAZIM A. FARISI MD PC
Active
Organization
HAZIM A. FARISI MD PC
Active
Other names
Friendship Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARY FARISI (OFFICE MANAGER)
(678) 714-5692
Entity
Organization
Contact information
Practice address
4965 FRIENDSHIP RD, SUITE 103, BUFORD, GA 30518-1700
(678) 714-5692
(678) 714-5693
Mailing address
4965 FRIENDSHIP RD, SUITE 103, BUFORD, GA 30518-1700
(678) 714-5692
(678) 714-5693
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
016201
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00457168C
—
GA
01
—
1700938123
INDIVIDUAL NPI
GA
01
—
1801078001
GROUP NPI
GA
01
—
GRP4668
GROUP PIN
GA
Enumeration date
11/29/2007
Last updated
08/17/2011
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