Individual
DR. SHELLA FAROOKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H.
Contact information
Practice address
27005 KNICKERBOCKER RD STE 100, BAY VILLAGE, OH 44140
(805) 620-2699
(800) 616-0084
Mailing address
27005 KNICKERBOCKER RD STE 100, BAY VILLAGE, OH 44140-2388
(888) 365-5514
(800) 616-0084
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
35078150
OH
2085R0202X
Diagnostic Radiology Physician
Primary
MD36487
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2196369
—
OH
Enumeration date
06/15/2005
Last updated
02/21/2019
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