Individual
FARAZ AHMAD KHAN DAHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6815 118TH AVE, KENOSHA, WI 53142-8420
(262) 857-5600
Mailing address
6815 118TH AVE, KENOSHA, WI 53142-8420
(262) 857-5600
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301116619
MI
208VP0014X
Interventional Pain Medicine Physician
Primary
2896
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100241342
—
WI
Enumeration date
07/08/2014
Last updated
10/06/2023
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