Provider Demographics
NPI:1609958388
Name:HAIDER, SYEDKASHIF B (MD)
Entity Type:Individual
Prefix:MR
First Name:SYEDKASHIF
Middle Name:B
Last Name:HAIDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:SYED KASHIF
Other - Middle Name:BILAL
Other - Last Name:HAIDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2406 RING RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-7940
Mailing Address - Country:US
Mailing Address - Phone:270-234-8866
Mailing Address - Fax:270-234-1355
Practice Address - Street 1:2406 RING RD
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-7940
Practice Address - Country:US
Practice Address - Phone:270-234-8866
Practice Address - Fax:270-234-1355
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33558207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY18K7OtherBLUE CROSS NUMBER
IN01046686AOtherMEDICAL LICENSE
KY0496484OtherCIGNA NUMBER
165678OtherAMERICAN BD OF INT MED CE
KY5720595OtherAETNA NUMBER
KY64553381Medicaid
KYKY33558OtherMEDICAL LICENSE
KY1120019OtherPASSPORT ID NUMBER
7255DOtherECFMG
7255DOtherECFMG
KY0689201Medicare ID - Type Unspecified
KY5720595OtherAETNA NUMBER
KY18K7OtherBLUE CROSS NUMBER