Provider Demographics
NPI:1508816315
Name:FARAH, NAZIH N (MD)
Entity type:Individual
Prefix:
First Name:NAZIH
Middle Name:N
Last Name:FARAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7505 METRO BLVD 400
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-3010
Mailing Address - Country:US
Mailing Address - Phone:612-573-2200
Mailing Address - Fax:612-573-2274
Practice Address - Street 1:1221 NICOLLET AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-2420
Practice Address - Country:US
Practice Address - Phone:612-573-2200
Practice Address - Fax:612-573-2274
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA608632085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1604246OtherMEDICA
MN246D4FAOtherBLUE CROSS BLUE SHIELD
MN2443920OtherAMERICA'S PPO
WI99112237OtherWI HEALTH INSURANCE RISK SHARING PLAN
IA0725143Medicaid
MN1047392OtherPREFERRED ONE
WI34893000Medicaid
MN544467000Medicaid
MN9250470OtherDAKOTA CARE
MNP00358403OtherRAILROAD MEDICARE MN
MNHP62980OtherHEALTHPARTNERS
MN9253125OtherPHCS/MULTIPLAN
MN544467000Medicaid
MN300003989Medicare PIN
WI005256135Medicare PIN
CAH28314Medicare UPIN
MN300003991Medicare PIN
WI006104070Medicare PIN