Provider Demographics
NPI:1992702476
Name:AHMAD, ASLAM M (MD)
Entity type:Individual
Prefix:
First Name:ASLAM
Middle Name:M
Last Name:AHMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 BEN ALI DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-8937
Mailing Address - Country:US
Mailing Address - Phone:859-236-6621
Mailing Address - Fax:859-238-0471
Practice Address - Street 1:1250 BEN ALI DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-8937
Practice Address - Country:US
Practice Address - Phone:859-236-6621
Practice Address - Fax:859-238-0471
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY31167207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000006889OtherCHA
KY000000112635OtherANTHEM FACETS#
KY2500620OtherUNITED HEALTHCARE
KY8977134OtherCIGNA
KY64311673Medicaid
KY2442786000OtherMCR PASSPORT ADVANTAGE
KY50001170/1083458OtherPASSPORT
KY953764217002OtherTRICARE
KY000000112635OtherANTHEM FACETS#
KY64311673Medicaid
KYP00208725Medicare PIN