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Individual

DR. AHMAD RAFEEK FARAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
2105 WEST ROAD, TRENTON, MI 48183
(734) 675-7777
(734) 675-7785
Mailing address
2105 WEST ROAD, TRENTON, MI 48183
(734) 675-7777
(734) 675-7785

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901002222
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1881852887
GROUP NPI
MI
01
4858218080
BC PIN
MI
01
50136
HEALTH PLAN OF MICHIGAN
01
5901002222
MICHIGAN STATE LICENSE
MI
01
9365124
PPOM COFINITY
MI
01
P58180002
MEDICARE PTAN
MI
Enumeration date
09/15/2006
Last updated
05/03/2011
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