Individual
FARAH N HAQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
401 9TH AVE NW, WATERTOWN, SD 57201-1548
(605) 882-7000
Mailing address
PO BOX 1210, WATERTOWN, SD 57201-6210
(605) 882-7000
(605) 882-7819
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
11515
SD
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
243080
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000537982
BCBS
IN
05
—
7100016220
—
KY
01
—
P00741870-DD1972 GRP
RAILROAD MEDICARE
NY
Enumeration date
08/22/2007
Last updated
12/27/2019
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