Individual
SHAIB OMAR FAROUQ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1525 DALLAS ST, AURORA, CO 80010-2014
(303) 285-0250
(303) 285-0139
Mailing address
1059 RACINE ST, AURORA, CO 80011-6323
(303) 285-0250
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
160810866
CO
347C00000X
Private Vehicle
APHM56
CO
Other
Enumeration date
05/27/2024
Last updated
05/27/2024
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