Faherty, Sean

Faherty, Sean is an individual health care provider with primary practice located at 2300 E 30Th St Bldg B, Ste 102, Farmington NM 87401-8990. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Faherty, Sean can be contacted via phone (505) 324-1000.

Contact Information

Primary practice address
2300 E 30Th St Bldg B, Ste 102 Farmington NM 87401-8990
Phone: (505) 324-1000
Fax: (505) 324-1199
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 98-47 New Mexico

Profile Details

NPI number 1174501191
LBN Legal business name Faherty, Sean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2006
Last updated Aug 20th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174501191 NPPES
New Jersey MEDICAID Q3766
New Jersey Other 32756
New Jersey Other 12988
New Jersey Other 201013243
New Jersey Other 080153393
New Jersey Other NM004194

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