Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | GF050792 | MI |
N | 207VG0400X | Gynecologist | GF050792 | MI |
N | 207VX0000X | Obstetrician | GF050792 | MI |
NPI | 1154398931 |
---|---|
Provider Name | Dr. Gary Edward Farhat |
First Address | Jackson, MI 49201-1847 |
Second Address | Jackson, MI 49201-1847 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2006 |
Last Update Date | 12/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1775828 | (05) | MI |
A15448 | (02) | MI |