Provider Demographics
NPI:1235464264
Name:ALHOMSI, BAHER (MD)
Entity Type:Individual
Prefix:
First Name:BAHER
Middle Name:
Last Name:ALHOMSI
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 1:906 E MOUNTAIN PKWY
Mailing Address - Street 2:
Mailing Address - City:SALYERSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41465-8379
Mailing Address - Country:US
Mailing Address - Phone:606-349-8100
Mailing Address - Fax:606-349-8150
Practice Address - Street 1:906 E MOUNTAIN PKWY
Practice Address - Street 2:
Practice Address - City:SALYERSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41465-8379
Practice Address - Country:US
Practice Address - Phone:606-349-8100
Practice Address - Fax:606-349-8150
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY31170207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine