Individual
AHMAD B FARIDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 PROSPERITY LANE, SUITE 203, LOGAN, WV 25601
(304) 752-8800
(304) 758-9000
Mailing address
300 PROSPERITY LN, SUITE 203, LOGAN, WV 25601-3743
(304) 752-8800
(304) 752-9000
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
22245
WV
207RN0300X
Nephrology Physician
42343
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100168950
—
KY
Enumeration date
06/16/2006
Last updated
01/07/2021
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