Provider Demographics
NPI:1710172978
Name:FARNEJAD, FARSHAD (MD)
Entity Type:Individual
Prefix:
First Name:FARSHAD
Middle Name:
Last Name:FARNEJAD
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 1:9141 GRANT ST STE 120
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9141 GRANT ST STE 120
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4318
Practice Address - Country:US
Practice Address - Phone:720-917-7050
Practice Address - Fax:720-622-9326
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-02096208600000X, 2086S0102X
CODR.0065762208600000X
OH57.013399208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery