Individual
MOHAMED FARHAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1205 S MAIN ST, SUITE 301, CROWN POINT, IN 46307-3676
(219) 661-1640
(219) 661-8066
Mailing address
100 E WAYNE ST STE 510, SOUTH BEND, IN 46601-2349
(574) 334-5390
(574) 334-5368
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-116126
IL
207RH0003X
Hematology & Oncology Physician
01066282A
IN
207RH0003X
Hematology & Oncology Physician
4301095492
MI
207RX0202X
Medical Oncology Physician
Primary
01066282A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104082809
—
MI
05
—
200947020
—
IN
01
—
P00760538
RR MEDICARE
IN
Enumeration date
08/01/2008
Last updated
01/03/2018
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