Provider Demographics
NPI:1093275075
Name:DHAHRI, AMINA (MD)
Entity Type:Individual
Prefix:
First Name:AMINA
Middle Name:
Last Name:DHAHRI
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 1:800 ROSE ST STE CC-402
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0093
Mailing Address - Country:US
Mailing Address - Phone:859-257-4488
Mailing Address - Fax:859-257-3531
Practice Address - Street 1:800 ROSE ST STE CC-402
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0093
Practice Address - Country:US
Practice Address - Phone:859-257-4488
Practice Address - Fax:859-257-0093
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KY56330207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program