Provider Demographics
NPI:1255426961
Name:QAYUM, FARIHA (MD)
Entity type:Individual
Prefix:DR
First Name:FARIHA
Middle Name:
Last Name:QAYUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3619 RICHARDSON SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-6022
Mailing Address - Country:US
Mailing Address - Phone:636-717-6700
Mailing Address - Fax:636-464-6755
Practice Address - Street 1:3619 RICHARDSON SQUARE DR
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MO
Practice Address - Zip Code:63010-6022
Practice Address - Country:US
Practice Address - Phone:636-717-6700
Practice Address - Fax:636-464-6755
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2017-03-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2004019699207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO126264Medicare UPIN