Provider Demographics
NPI:1770376527
Name:FARAH, MOHAMED ABDINUR
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:ABDINUR
Last Name:FARAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 N GAMMON RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1195
Mailing Address - Country:US
Mailing Address - Phone:507-319-4662
Mailing Address - Fax:
Practice Address - Street 1:1108 N GAMMON RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-1195
Practice Address - Country:US
Practice Address - Phone:507-319-4662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide