Individual
JOHANN DAVID FARLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8300 BROADWAY STE D2, MERRILLVILLE, IN 46410-8603
(219) 649-0044
(219) 649-0055
Mailing address
8300 BROADWAY STE D2, MERRILLVILLE, IN 46410-8603
(219) 757-5780
(219) 769-1609
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01060680A
IN
207Q00000X
Family Medicine Physician
46905-20
WI
207Q00000X
Family Medicine Physician
A89493
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200522790
—
IN
Enumeration date
04/18/2006
Last updated
03/26/2024
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