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Search › Indiana › 207Q00000X

Ibad Farooqui, MD

NPI 1427499318 · on the registry since 2013

Practice

Address
402 E Main St
Fort Wayne, IN 46802
Phone
(260) 425-2630
Fax
(260) 425-2631
Organisation at this address
Revivd Recovery And Wellness Fort Wayne Llc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
207Q00000X
207Q00000X
Also registered as
207Q00000X
390200000X
Licence states on file
MI, IN
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2020-09-28

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana