Provider Demographics
NPI:1164489399
Name:FARAH, AHMED SALEH (MD)
Entity Type:Individual
Prefix:MR
First Name:AHMED
Middle Name:SALEH
Last Name:FARAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1060 FAIRFAX PARK
Mailing Address - Street 2:STE B
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406
Mailing Address - Country:US
Mailing Address - Phone:205-758-6471
Mailing Address - Fax:205-758-6472
Practice Address - Street 1:1060 FAIRFAX PARK
Practice Address - Street 2:STE B
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406
Practice Address - Country:US
Practice Address - Phone:205-758-6471
Practice Address - Fax:205-758-6472
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL18902208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000028532Medicaid
AL51028532OtherBCBS
AL000028532Medicare PIN
AL51028532OtherBCBS
F84054Medicare UPIN