Provider Demographics
NPI:1700345667
Name:FARUQUI, ADNAN MUHAMMAD IBNA (MD)
Entity type:Individual
Prefix:
First Name:ADNAN
Middle Name:MUHAMMAD IBNA
Last Name:FARUQUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1800 BUCKNER ST STE C120
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4453
Mailing Address - Country:US
Mailing Address - Phone:318-213-2761
Mailing Address - Fax:318-681-8047
Practice Address - Street 1:2501 GREENWOOD RD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-3905
Practice Address - Country:US
Practice Address - Phone:318-631-1584
Practice Address - Fax:318-635-8322
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA348374207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology