Provider Demographics
NPI:1952364366
Name:FARAH, NAGUIB HANI HANNA (MD)
Entity Type:Individual
Prefix:DR
First Name:NAGUIB
Middle Name:HANI HANNA
Last Name:FARAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NAGUIB
Other - Middle Name:H
Other - Last Name:FARAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:200 CORPORATE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3870
Mailing Address - Country:US
Mailing Address - Phone:800-893-9698
Mailing Address - Fax:
Practice Address - Street 1:500 MORVEN RD
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-2745
Practice Address - Country:US
Practice Address - Phone:800-893-9698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101268923207Q00000X
NC9401403207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8931229Medicaid
NCF96438Medicare UPIN
NC2207177MMedicare ID - Type Unspecified