Provider Demographics
NPI:1477966935
Name:BABAR, FAIZAN (MD)
Entity Type:Individual
Prefix:
First Name:FAIZAN
Middle Name:
Last Name:BABAR
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 1:1401 HARRODSBURG RD STE C335
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-1791
Mailing Address - Country:US
Mailing Address - Phone:859-276-5355
Mailing Address - Fax:859-277-1843
Practice Address - Street 1:1401 HARRODSBURG RD STE C335
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-1791
Practice Address - Country:US
Practice Address - Phone:859-276-5355
Practice Address - Fax:859-277-1843
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDXXXXXXXXXXXXXXXX390200000X
KY52199207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDN/AMedicaid
MDN/AMedicare UPIN