Provider Demographics
NPI:1245408426
Name:ALHAJERI, ABDULNASSER AHMED YOUSUF (MD)
Entity Type:Individual
Prefix:
First Name:ABDULNASSER
Middle Name:AHMED YOUSUF
Last Name:ALHAJERI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 E CAMPUS VIEW BLVD
Mailing Address - Street 2:STE 160
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-8634
Mailing Address - Country:US
Mailing Address - Phone:614-340-7740
Mailing Address - Fax:614-340-7742
Practice Address - Street 1:202 BEVINS LN
Practice Address - Street 2:ROM.123
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-6178
Practice Address - Country:US
Practice Address - Phone:859-323-2401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2019-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO20100207222085D0003X
KY435852085D0003X, 2085P0229X, 2085R0202X, 2085R0204X, 2085N0700X
OH35.1368262085D0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Neuroimaging
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100139340Medicaid
KYP400022929Medicare PIN