Provider Demographics
NPI:1801104815
Name:FARIN, ALMA DONNA (DO)
Entity type:Individual
Prefix:
First Name:ALMA
Middle Name:DONNA
Last Name:FARIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9307 CALUMET AVE STE D1
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2892
Mailing Address - Country:US
Mailing Address - Phone:219-703-9399
Mailing Address - Fax:219-703-6704
Practice Address - Street 1:9307 CALUMET AVE STE D1
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2892
Practice Address - Country:US
Practice Address - Phone:219-703-9399
Practice Address - Fax:219-703-6704
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101019039207V00000X
IN02004443A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201238070Medicaid