Individual provider · NPI-1

Dr. Rafik Farag, MD

Family Medicine · Peru, IN

NPI number1629208251
StatusActive
Last updated in NPPESJul 6, 2011

Details

NPI
1629208251
Entity type
Individual (NPI-1)
Name
Dr. Rafik Farag
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jul 16, 2009
Last updated
Jul 6, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine01021342AINYes

Practice location

1694 W Logansport Rd.
Community Health Center Of Miami County
Peru, IN 46970

Phone 765-472-2519 · Fax 765-472-3192

Mailing address

8003 Castleway Drive
Indiana Health Centers, INC.
Indianapolis, IN 46250

Phone 317-576-1335 · Fax 317-576-1339

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