Provider Demographics
NPI:1790739498
Name:FARRUKH JAVAID MD PLLC
Entity Type:Organization
Organization Name:FARRUKH JAVAID MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARRUKH
Authorized Official - Middle Name:
Authorized Official - Last Name:JAVAID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-845-0545
Mailing Address - Street 1:11102 SUNRISE BLVD E
Mailing Address - Street 2:SUITE 109
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374-8846
Mailing Address - Country:US
Mailing Address - Phone:253-845-0545
Mailing Address - Fax:253-845-4733
Practice Address - Street 1:11102 SUNRISE BLVD E
Practice Address - Street 2:SUITE 109
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374-8846
Practice Address - Country:US
Practice Address - Phone:253-845-0545
Practice Address - Fax:253-845-4733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty