Organization
MUNSTER PRIMARY CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASIF H FAROOQUI MD (PRESIDENT)
(901) 619-5629
Entity
Organization
Contact information
Practice address
9731 PRAIRIE AVE, HIGHLAND, IN 46322-3616
(219) 301-5212
(708) 221-6766
Mailing address
PO BOX 5580, VILLA PARK, IL 60181-5305
(708) 478-7201
(708) 221-6766
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01063801A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01063801A
LICENSE
IN
Enumeration date
09/10/2015
Last updated
12/27/2015
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