Organization
HAZIM A. FARISI MD PC
Active
Other names
Friendship Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARY FARISI (OFFICE MANAGER)
(678) 714-5692
Entity
Organization
Contact information
Practice address
4965 FRIENDSHIP RD, SUITE 103, BUFORD, GA 30518-1700
(678) 714-5692
(678) 714-5693
Mailing address
4965 FRIENDSHIP RD, SUITE 103, BUFORD, GA 30518-1700
(678) 714-5692
(678) 714-5693
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
016201
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00457168C
—
GA
01
—
1700938123
INDIVIDUAL NPI
GA
01
—
1801078001
GROUP NPI
GA
01
—
GRP4668
GROUP PIN
GA
Enumeration date
11/29/2007
Last updated
08/17/2011
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