Provider Demographics
NPI:1134237936
Name:SARAFF, SUMA K (MD)
Entity type:Individual
Prefix:DR
First Name:SUMA
Middle Name:K
Last Name:SARAFF
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:PO BOX 911065
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-1065
Mailing Address - Country:US
Mailing Address - Phone:859-278-1982
Mailing Address - Fax:859-278-0093
Practice Address - Street 1:1401 HARRODSBURG RD
Practice Address - Street 2:STE B395
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3751
Practice Address - Country:US
Practice Address - Phone:859-278-1982
Practice Address - Fax:859-278-0093
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY35123207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
320035194OtherBLUEGRASS FAMILY HEALTH
KY64018096Medicaid
P00157716OtherDBA RAILROAD
0007996296OtherAETNA
0741701OtherMEDICARE LEGACY
320035194OtherUMWA
320035194OtherHUMANA
000000256300OtherBCBS
H53076Medicare UPIN
KY64018096Medicaid