Provider Demographics
NPI:1043291081
Name:NAZEER, KHURRAM (MD)
Entity Type:Individual
Prefix:
First Name:KHURRAM
Middle Name:
Last Name:NAZEER
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:234 E GRAY ST
Mailing Address - Street 2:SUITE 858
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1900
Mailing Address - Country:US
Mailing Address - Phone:502-583-1799
Mailing Address - Fax:502-583-1792
Practice Address - Street 1:234 EAST GRAY
Practice Address - Street 2:SUITE 858
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1715
Practice Address - Country:US
Practice Address - Phone:502-583-1799
Practice Address - Fax:502-583-1792
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2011-10-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY38902207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64086259Medicaid
KYG43249Medicare UPIN
KY64086259Medicaid