Provider Demographics
NPI:1538695598
Name:FARHAN, HISHAM AHMED (MD)
Entity Type:Individual
Prefix:
First Name:HISHAM
Middle Name:AHMED
Last Name:FARHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:827 LINDEN AVE # B-2043
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-4606
Mailing Address - Country:US
Mailing Address - Phone:443-682-6873
Mailing Address - Fax:410-836-3846
Practice Address - Street 1:827 LINDEN AVE # B-2043
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4606
Practice Address - Country:US
Practice Address - Phone:443-682-6873
Practice Address - Fax:410-836-3846
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11559200207R00000X, 207RE0101X
PAMT212816207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine