Provider Demographics
NPI:1962473132
Name:HUSAIN, FARAH ANWARI (MD)
Entity Type:Individual
Prefix:DR
First Name:FARAH
Middle Name:ANWARI
Last Name:HUSAIN
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 1:5817 E LEITH LN
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4851
Mailing Address - Country:US
Mailing Address - Phone:703-868-1337
Mailing Address - Fax:
Practice Address - Street 1:1111 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2612
Practice Address - Country:US
Practice Address - Phone:520-694-2763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO49875208600000X
OR173564208600000X
WAMD00042564208600000X
AZ66072208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO021686OtherKAISER COMMERCIAL NUMBER
CO33224234Medicaid
AZ1437529245Medicaid
OR173564OtherOREGON LICENSE