Individual
FARHAD K SHOKOOHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2393 SCHUST RD, GREAT LAKES EYE INSTITUTE, SAGINAW, MI 48603-1334
(989) 793-2820
(989) 793-9132
Mailing address
2393 SCHUST RD, GREAT LAKES EYE INSTITUTE, SAGINAW, MI 48603-1334
(989) 793-2820
(989) 793-9132
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301040619
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0467800001
ADMINASTAR
—
01
—
0467800002
ADMINASTAR
—
01
—
0467800004
ADMINASTAR
—
01
—
0467800005
ADMINASTAR
—
01
—
0467800006
ADMINASTAR
—
05
—
1359493
—
MI
01
—
180G300890
BLUE CARE NETWORK
MI
05
—
2622510
—
MI
01
—
4301040619
LICENSE NUMBER
MI
01
—
CA3610
RAILROAD MEDICARE
MI
Enumeration date
08/26/2005
Last updated
09/18/2023
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