Provider Demographics
NPI:1346241841
Name:NAWAB, AKBAR (MD)
Entity Type:Individual
Prefix:
First Name:AKBAR
Middle Name:
Last Name:NAWAB
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 1:13151 MAGISTERIAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4103
Mailing Address - Country:US
Mailing Address - Phone:502-587-1236
Mailing Address - Fax:502-587-0126
Practice Address - Street 1:13151 MAGISTERIAL DR STE 200
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223
Practice Address - Country:US
Practice Address - Phone:502-587-1236
Practice Address - Fax:502-587-0126
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33051207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYG63811Medicare UPIN
KY0200917Medicare PIN
KY1269518Medicare PIN