1598743361 NPI number — RASHID FAIYAZ M.D.

Table of content: RASHID FAIYAZ M.D. (NPI 1598743361)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598743361 NPI number — RASHID FAIYAZ M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FAIYAZ
Provider First Name:
RASHID
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598743361
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/28/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 HIGHLANDER POINT DR
Provider Second Line Business Mailing Address:
SUITE 204
Provider Business Mailing Address City Name:
FLOYDS KNOBS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47119-9465
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-542-4921
Provider Business Mailing Address Fax Number:
812-949-5966

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1850 STATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ALBANY
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47150-4990
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-944-7701
Provider Business Practice Location Address Fax Number:
812-981-6505
Provider Enumeration Date:
01/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , with the licence number:  01062019A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RN0300X , with the licence number: 35078839 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208D00000X , with the licence number: 36526 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00992178 . This is a "RR MEDICARE KY - NICC" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 200315200 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2221241 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: M400063433 . This is a "MEDICARE - NICC" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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