Individual
SHARIFEH FARASAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
120 MEDICAL PARK DR, SUITE 300, BRIDGEPORT, WV 26330-9012
(304) 624-7200
(304) 624-0026
Mailing address
120 MEDICAL PARK DR, SUITE 300, BRIDGEPORT, WV 26330-9012
(304) 624-7200
(304) 624-0026
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25886
WV
207N00000X
Dermatology Physician
A123744
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810027666
—
WV
Enumeration date
04/03/2009
Last updated
01/23/2015
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