Provider Demographics
NPI:1053429191
Name:FARBER, ANDREW S (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:S
Last Name:FARBER
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 1:76 W SPRINGHILL DR
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-8767
Mailing Address - Country:US
Mailing Address - Phone:812-299-2020
Mailing Address - Fax:812-299-0519
Practice Address - Street 1:76 W SPRINGHILL DR
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-8767
Practice Address - Country:US
Practice Address - Phone:812-299-2020
Practice Address - Fax:812-299-0519
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01035971A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0733780001OtherOLD MEDICARE NSC
IN100252550Medicaid
IN0733780001OtherOLD MEDICARE NSC
INC45780Medicare UPIN
INP00379407Medicare PIN