1992702476 NPI number — ASLAM M AHMAD MD

Table of content: ASLAM M AHMAD MD (NPI 1992702476)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992702476 NPI number — ASLAM M AHMAD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AHMAD
Provider First Name:
ASLAM
Provider Middle Name:
M
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:
1992702476
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/02/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1250 BEN ALI DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DANVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40422-8937
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-236-6621
Provider Business Mailing Address Fax Number:
859-238-0471

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1250 BEN ALI DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40422-8937
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-236-6621
Provider Business Practice Location Address Fax Number:
859-238-0471
Provider Enumeration Date:
06/30/2005

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: 207RC0000X , with the licence number:  31167 , 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: 000000006889 . This is a "CHA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000112635 . This is a "ANTHEM FACETS#" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 2500620 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 8977134 . This is a "CIGNA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 64311673 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2442786000 . This is a "MCR PASSPORT ADVANTAGE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50001170/1083458 . This is a "PASSPORT" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 953764217002 . This is a "TRICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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