1487879599 NPI number — MUHAMMAD RAFIUDDIN MD

Table of content: MUHAMMAD RAFIUDDIN MD (NPI 1487879599)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487879599 NPI number — MUHAMMAD RAFIUDDIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAFIUDDIN
Provider First Name:
MUHAMMAD
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:
RAFI UD DIN
Provider Other First Name:
MUHAMMAD
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1487879599
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/27/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6018
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLORENCE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41022-6018
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-912-7716
Provider Business Mailing Address Fax Number:
859-757-4923

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6909 BURLINGTON PIKE STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLORENCE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41042-1618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-912-7716
Provider Business Practice Location Address Fax Number:
859-757-4923
Provider Enumeration Date:
04/16/2007

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: 207RA0000X , with the licence number:  TP143 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RN0300X , with the licence number: 40822 , 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: 200871890 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200871890 . This is a "MD WISE- NORTON" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50015466 . This is a "PASSPORT- NORTON" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 089945 . This is a "SIHO- NORTON" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000023027W . This is a "HUMANA- NORTON" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 2853837000 . This is a "PASSPORT ADVANTAGE- NORT." identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1901496 . This is a "CIGNA- NORTON" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 7100009440 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00439736 . This is a "RAILROAD MEDICARE-NORTON" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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