Provider Demographics
NPI:1629049283
Name:FARAH, GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:FARAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3909 ORANGE PL STE 3300
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4482
Mailing Address - Country:US
Mailing Address - Phone:216-844-8252
Mailing Address - Fax:216-844-8954
Practice Address - Street 1:3909 ORANGE PL STE 3300
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4482
Practice Address - Country:US
Practice Address - Phone:216-844-8252
Practice Address - Fax:216-844-8954
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11380207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100506571Medicaid
NV1629049283Medicaid
I29446Medicare UPIN
NVV100740Medicare PIN
NV1629049283Medicaid