1740330398 NPI number — GHIAS MOHAMAD ARAR MD

Table of content: GHIAS MOHAMAD ARAR MD (NPI 1740330398)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740330398 NPI number — GHIAS MOHAMAD ARAR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARAR
Provider First Name:
GHIAS
Provider Middle Name:
MOHAMAD
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1740330398
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 23568
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40223-0568
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-254-4014
Provider Business Mailing Address Fax Number:
502-254-4015

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13806 LAKE POINT CIR
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40223-4222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-254-4014
Provider Business Practice Location Address Fax Number:
502-254-4015
Provider Enumeration Date:
01/12/2007

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: 2084N0400X , with the licence number:  32411 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2435739000 . This is a "PASSPORT ADVANTAGE GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2442006000 . This is a "PASSPORT ADVANTAGE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 50000296 . This is a "PASSPORT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000052175 . This is a "ANTHEM BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5853602 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 64324114 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0500150 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 130019966 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com