Provider Demographics
NPI:1295775534
Name:FAROOQ, UMAR (MD)
Entity type:Individual
Prefix:DR
First Name:UMAR
Middle Name:
Last Name:FAROOQ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3034 KNIGHTS ROAD
Mailing Address - Street 2:KNIGHTS MEDICAL ASSOCIATES
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020
Mailing Address - Country:US
Mailing Address - Phone:215-638-7400
Mailing Address - Fax:215-244-6524
Practice Address - Street 1:3034 KNIGHTS ROAD
Practice Address - Street 2:KNIGHTS MEDICAL ASSOCIATES
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020
Practice Address - Country:US
Practice Address - Phone:215-638-7400
Practice Address - Fax:215-244-6524
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-061689-L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01692663Medicaid
PAG84988Medicare UPIN
PA022653Medicare ID - Type Unspecified