Provider Demographics
NPI:1578542700
Name:AL FARUQI, TAYMA (MD)
Entity Type:Individual
Prefix:
First Name:TAYMA
Middle Name:
Last Name:AL FARUQI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E CAMPUS VIEW BLVD
Mailing Address - Street 2:STE 160
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4647
Mailing Address - Country:US
Mailing Address - Phone:614-396-4750
Mailing Address - Fax:614-396-4742
Practice Address - Street 1:3525 OLENTANGY RIVER RD
Practice Address - Street 2:STE 5360
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3937
Practice Address - Country:US
Practice Address - Phone:614-340-7747
Practice Address - Fax:614-340-7742
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350701202085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH300095340OtherRR MEDICARE
OH0247754Medicaid
OH0247754Medicaid
OH0819382Medicare PIN