Individual
ATIF FARAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 E PARK AVE, STATE COLLEGE, PA 16803-6701
(814) 231-7000
Mailing address
3945 S ATHERTON ST, STE A, STATE COLLEGE, PA 16801-8308
(814) 235-3898
(814) 235-3899
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD070335L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017954640002
—
PA
01
—
50020159
KEYSTONE HEALTH PLAN CENT
PA
01
—
57757
GEISINGER HEALTH PLAN
PA
01
—
738002
HIGHMARK BLUE SHIELD
PA
01
—
P00019734
RAILROAD MEDICARE
PA
Enumeration date
07/12/2006
Last updated
06/19/2018
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