1609958388 NPI number — MR. SYEDKASHIF B HAIDER M.D.

Table of content: MR. SYEDKASHIF B HAIDER M.D. (NPI 1609958388)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609958388 NPI number — MR. SYEDKASHIF B HAIDER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAIDER
Provider First Name:
SYEDKASHIF
Provider Middle Name:
B
Provider Name Prefix Text:
MR.
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:
HAIDER
Provider Other First Name:
SYED KASHIF
Provider Other Middle Name:
BILAL
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1609958388
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2406 RING RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELIZABETHTOWN
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42701-7940
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-234-8866
Provider Business Mailing Address Fax Number:
270-234-1355

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2406 RING RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELIZABETHTOWN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42701-7940
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-234-8866
Provider Business Practice Location Address Fax Number:
270-234-1355
Provider Enumeration Date:
10/20/2006

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: 207RG0100X , with the licence number:  33558 , 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: 18K7 . This is a "BLUE CROSS NUMBER" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 01046686A . This is a "MEDICAL LICENSE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 0496484 . This is a "CIGNA NUMBER" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 165678 . This is a "AMERICAN BD OF INT MED CE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5720595 . This is a "AETNA NUMBER" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 64553381 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: KY33558 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1120019 . This is a "PASSPORT ID NUMBER" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 7255D . This is a "ECFMG" identifier . This identifiers is of the category "OTHER".




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