Basic Information
Provider Information
NPI: 1508811191
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FARRIMOND
FirstName: DONALD
MiddleName: MATTHEW
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 601 RALSTON STREET
Address2: SUITE 100
City: RENO
State: NV
PostalCode: 89503
CountryCode: US
TelephoneNumber: 7757861110
FaxNumber: 7757888075
Practice Location
Address1: 601 RALSTON STREET
Address2: SUITE 100
City: RENO
State: NV
PostalCode: 89503
CountryCode: US
TelephoneNumber: 7757861110
FaxNumber: 7757888075
Other Information
ProviderEnumerationDate: 05/23/2006
LastUpdateDate: 06/06/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X10999NVY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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