1336101542 NPI number — IRFAN DAHAR MD

Table of content: IRFAN DAHAR MD (NPI 1336101542)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336101542 NPI number — IRFAN DAHAR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAHAR
Provider First Name:
IRFAN
Provider Middle Name:
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:
1336101542
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1265
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MASON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-528-4000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6730 ROOSEVELT AVE STE 301
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45005-5736
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-928-3339
Provider Business Practice Location Address Fax Number:
513-928-3382
Provider Enumeration Date:
04/04/2006

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: 2084P0800X , with the licence number:  35-076498 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 64033566 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2142149 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 260047004 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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