Provider Demographics
NPI:1770546483
Name:NAMIN, FARID M (MD)
Entity type:Individual
Prefix:
First Name:FARID
Middle Name:M
Last Name:NAMIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FARID
Other - Middle Name:MEHDIZADEH
Other - Last Name:NAMIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:18640 E 38TH TER S
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-2304
Mailing Address - Country:US
Mailing Address - Phone:816-229-1191
Mailing Address - Fax:816-229-1198
Practice Address - Street 1:18640 E 38TH TER S
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2304
Practice Address - Country:US
Practice Address - Phone:816-229-1191
Practice Address - Fax:816-229-1198
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-30181207RG0100X
MO20060092892084P0800X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry