Provider Demographics
NPI:1861492373
Name:ZUBERI, BEYLA (MD)
Entity Type:Individual
Prefix:
First Name:BEYLA
Middle Name:
Last Name:ZUBERI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 RIVER RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-1010
Mailing Address - Country:US
Mailing Address - Phone:502-814-3175
Mailing Address - Fax:502-426-5493
Practice Address - Street 1:10727 WORTHINGTON LN
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-9586
Practice Address - Country:US
Practice Address - Phone:502-544-6442
Practice Address - Fax:502-426-5493
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37992207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64066749Medicaid
H86949Medicare UPIN
KY64066749Medicaid