Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 30369 | AZ |
N | 207RC0000X | Internist - Cardiovascular Disease | 36343 | WI |
N | 207RI0011X | Interventional Cardiology | 36343 | WI |
NPI | 1083659700 |
---|---|
Provider Name | Dr. Fahim Haider Jafary |
First Address | Prescott, AZ 86304-0880 |
Second Address | Janesville, WI 53548-2940 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 01/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
34671900 | (05) | WI |
JAFARFAH | MERCYCARE INSURANCE (01) | WI |
Q08850 | (02) |