Provider Demographics
NPI:1780612481
Name:FAROOQ, UMER (MD)
Entity type:Individual
Prefix:
First Name:UMER
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 1:239 MT. PARKWAY SPUR
Mailing Address - Street 2:
Mailing Address - City:CAMPTON
Mailing Address - State:KY
Mailing Address - Zip Code:41301
Mailing Address - Country:US
Mailing Address - Phone:606-668-6932
Mailing Address - Fax:
Practice Address - Street 1:239 MT. PARKWAY SPUR
Practice Address - Street 2:
Practice Address - City:CAMPTON
Practice Address - State:KY
Practice Address - Zip Code:41301
Practice Address - Country:US
Practice Address - Phone:606-668-6932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-13275207P00000X
KY38853207R00000X
TN43746207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64090608Medicaid
KYP00228570OtherRAILROAD MEDICARE
TN000751730Medicaid
KYI25794Medicare UPIN