Provider Demographics
NPI:1235242272
Name:UBAID, FARAH (MD)
Entity Type:Individual
Prefix:
First Name:FARAH
Middle Name:
Last Name:UBAID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18101 OAKWOOD BLVD
Mailing Address - Street 2:EMERGENCY MEDICINE DEPARTMENT
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-4089
Mailing Address - Country:US
Mailing Address - Phone:313-593-8780
Mailing Address - Fax:313-436-2864
Practice Address - Street 1:38935 ANN ARBOR RD
Practice Address - Street 2:CREDENTIALING/PAYER CONTRACTING
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-3397
Practice Address - Country:US
Practice Address - Phone:734-805-0477
Practice Address - Fax:866-250-6385
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301073757207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301073757OtherPHYSICIAN LICENSE