Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD-41631 | IA |
N | 2084N0402X | Child Neurologist | MD-41631 | IA |
NPI | 1285863290 |
---|---|
Provider Name | Farouq Thabet |
First Address | Des Moines, IA 50305-1475 |
Second Address | Des Moines, IA 50314-3005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2009 |
Last Update Date | 04/03/2021 |