Provider Demographics
NPI:1225810351
Name:FARAH, AHMED
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:FARAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 UNIVERSITY AVE W STE 181
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-2879
Mailing Address - Country:US
Mailing Address - Phone:161-225-9771
Mailing Address - Fax:
Practice Address - Street 1:1821 UNIVERSITY AVE W STE 181
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-2879
Practice Address - Country:US
Practice Address - Phone:161-225-9771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver