Individual
SEFERINO FARIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12800 MISSISSIPPI PKWY STE C101, CROWN POINT, IN 46307-6901
(219) 661-0444
(219) 226-1222
Mailing address
1040 SIERRA DR STE 400, GREENWOOD, IN 46143-7241
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01053482A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200280620
—
IN
01
—
IN1798
MEDICARE PTAN
—
Enumeration date
06/15/2005
Last updated
04/02/2021
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