Provider Demographics
NPI:1780603563
Name:FARAH, MICHEL G (MD)
Entity type:Individual
Prefix:
First Name:MICHEL
Middle Name:G
Last Name:FARAH
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 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-037958207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH363522OtherWELLCARE
OH000000539422OtherANTHEM
OH737324OtherBUCKEYE
OHP00432047OtherRAILROAD MEDICARE
OH000000224266OtherUNISON
OH0639673OtherAETNA
OH0276759Medicaid
OH700006769OtherRAILROAD MEDICARE
OH000000224266OtherUNISON
OH700006769OtherRAILROAD MEDICARE
OH737324OtherBUCKEYE