Provider Demographics
NPI:1245459353
Name:LUNG DISEASE SPECIALISTS
Entity type:Organization
Organization Name:LUNG DISEASE SPECIALISTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WASEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-236-9203
Mailing Address - Street 1:439 W WALNUT ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-1852
Mailing Address - Country:US
Mailing Address - Phone:859-236-9203
Mailing Address - Fax:859-236-6754
Practice Address - Street 1:439 W WALNUT ST
Practice Address - Street 2:SUITE 201
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-1852
Practice Address - Country:US
Practice Address - Phone:859-236-9203
Practice Address - Fax:859-236-6754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33677207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00011340OtherRAILROAD MEDICARE
KY64064033Medicaid
KY64064033Medicaid