Provider Demographics
NPI:1215933080
Name:HAMAD, REEM (MD)
Entity type:Individual
Prefix:
First Name:REEM
Middle Name:
Last Name:HAMAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 950248
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0248
Mailing Address - Country:US
Mailing Address - Phone:502-253-1035
Mailing Address - Fax:502-253-1037
Practice Address - Street 1:6041 TIMBER RIDGE DR
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-8134
Practice Address - Country:US
Practice Address - Phone:502-228-2225
Practice Address - Fax:502-228-2226
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY31722207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64317225Medicaid
KY000000341431OtherANTHEM
KY0795638Medicare PIN
KY0538687Medicare PIN
KY00714034Medicare PIN
G38544Medicare UPIN
KY0538585Medicare PIN
KY000000341431OtherANTHEM
KY64317225Medicaid
KY0538787Medicare PIN