Provider Demographics
NPI:1255583407
Name:SHEREEN, FARHAT (MD)
Entity type:Individual
Prefix:
First Name:FARHAT
Middle Name:
Last Name:SHEREEN
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:300 MEDICAL PLZ
Mailing Address - Street 2:STE. 100
Mailing Address - City:LAKE SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-1481
Mailing Address - Country:US
Mailing Address - Phone:636-625-8300
Mailing Address - Fax:636-625-8301
Practice Address - Street 1:300 MEDICAL PLZ
Practice Address - Street 2:STE. 100
Practice Address - City:LAKE SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-1481
Practice Address - Country:US
Practice Address - Phone:636-625-8300
Practice Address - Fax:636-625-8301
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2011-06-27
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Provider Licenses
StateLicense IDTaxonomies
MO2004017395207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology