Provider Demographics
NPI:1043601875
Name:SAID, MOHAMMED ADNAN (MD)
Entity Type:Individual
Prefix:MR
First Name:MOHAMMED
Middle Name:ADNAN
Last Name:SAID
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:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:502-588-0328
Mailing Address - Fax:
Practice Address - Street 1:401 E CHESTNUT ST UNIT 520
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-5713
Practice Address - Country:US
Practice Address - Phone:502-588-4740
Practice Address - Fax:502-588-9537
Is Sole Proprietor?:No
Enumeration Date:2015-02-16
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-47055208800000X
KY55794208800000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100764800Medicaid
IN300054950Medicaid