Provider Demographics
NPI:1932135613
Name:FARAG, ROSEMARY R (MD)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:R
Last Name:FARAG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-7494
Practice Address - Fax:216-286-6341
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-077988207ZP0101X, 207ZP0102X, 207ZB0001X, 207ZC0006X, 207ZP0104X, 207ZP0105X, 207ZC0500X, 207ZD0900X, 207ZF0201X, 207ZH0000X, 207ZI0100X, 207ZM0300X, 207ZP0007X, 207ZN0500X, 207ZP0213X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology
No207ZP0104XAllopathic & Osteopathic PhysiciansPathologyChemical Pathology
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
No207ZI0100XAllopathic & Osteopathic PhysiciansPathologyImmunopathology
No207ZM0300XAllopathic & Osteopathic PhysiciansPathologyMedical Microbiology
No207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic Pathology
No207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology
No207ZP0213XAllopathic & Osteopathic PhysiciansPathologyPediatric Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000224265OtherUNISON
OH000000528750OtherANTHEM
OH363521OtherWELLCARE
OHP00024293OtherRAILROAD MEDICARE
OH1101380OtherUHC
OH7409501OtherAETNA
OH000000311096OtherANTHEM
OH0127464OtherBCMH
PA1024197860001Medicaid
OH2406980Medicaid
MI1932135613Medicaid
OH743254OtherBUCKEYE
OHP00412456OtherRAILROAD MEDICARE
OH000000528750OtherANTHEM
MI1932135613Medicaid
OHFA4107302Medicare PIN