Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301105556 | MI |
Y | 2080P0203X | Pediatric Critical Care Doctor | 4301105556 | MI |
NPI | 1043625098 |
---|---|
Provider Name | Mohamed Hani Farhat |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2014 |
Last Update Date | 07/07/2020 |