Provider Demographics
NPI:1891749305
Name:BABAR, MUHAMMAD (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
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:PO BOX 950151
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0151
Mailing Address - Country:US
Mailing Address - Phone:502-543-9124
Mailing Address - Fax:502-543-0844
Practice Address - Street 1:802 OVERHILL DR
Practice Address - Street 2:BUSINESS OFFICE
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-7252
Practice Address - Country:US
Practice Address - Phone:502-543-9124
Practice Address - Fax:502-543-0844
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38794207R00000X, 207RG0300X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200524400Medicaid
KY64101892Medicaid
KY01190001Medicare PIN
IN200524400Medicaid
INM400030119Medicare PIN