Provider Demographics
NPI:1790339539
Name:ATTIAH, AHAD (MD)
Entity Type:Individual
Prefix:
First Name:AHAD
Middle Name:
Last Name:ATTIAH
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 1:225 ABRAHAM FLEXNER WAY STE 850
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1858
Mailing Address - Country:US
Mailing Address - Phone:502-562-0312
Mailing Address - Fax:
Practice Address - Street 1:225 ABRAHAM FLEXNER WAY STE 850
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1858
Practice Address - Country:US
Practice Address - Phone:502-562-0312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYFT5962082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYFT596OtherSTATE LICENSE