Provider Demographics
NPI:1447353982
Name:FAROOQUI, SALAHUDDIN (MD)
Entity type:Individual
Prefix:
First Name:SALAHUDDIN
Middle Name:
Last Name:FAROOQUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:EUTAW
Mailing Address - State:AL
Mailing Address - Zip Code:35462
Mailing Address - Country:US
Mailing Address - Phone:205-372-4035
Mailing Address - Fax:205-372-1228
Practice Address - Street 1:509 WILSON AVE
Practice Address - Street 2:
Practice Address - City:EUTAW
Practice Address - State:AL
Practice Address - Zip Code:35462-1064
Practice Address - Country:US
Practice Address - Phone:205-372-4035
Practice Address - Fax:205-372-1228
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20504207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51504236OtherBC
AL009958180Medicaid
50755OtherNO DESCRIPTION
50755OtherNO DESCRIPTION
AL009958180Medicaid