Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 35-089046 | OH |
Y | 111NI0900X | Internist | 35-089046 | OH |
N | 207RG0300X | Geriatric Medicine | 35-089046 | OH |
NPI | 1073693925 |
---|---|
Provider Name | Shermeen Taj Farukhi |
First Address | Columbus, OH 43271-4328 |
Second Address | Mentor, OH 44060-8723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 04/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2789906 | (05) | OH |
I73914 | (02) |