Individual
DR. FADI NIAZY ABU-FARSAKH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
4301507530
MI
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
4301507530
MI
208D00000X
General Practice Physician
4301507530
MI
390200000X
Student in an Organized Health Care Education/Training Program
320211
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2503201
—
LA
Enumeration date
06/25/2019
Last updated
07/18/2022
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