Provider Demographics
NPI:1265546139
Name:SOMERSET CARDIOLOGY
Entity type:Organization
Organization Name:SOMERSET CARDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KHALID
Authorized Official - Middle Name:M
Authorized Official - Last Name:SALEH
Authorized Official - Suffix:II
Authorized Official - Credentials:M D
Authorized Official - Phone:606-679-1189
Mailing Address - Street 1:402 BOGLE ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2870
Mailing Address - Country:US
Mailing Address - Phone:606-679-1189
Mailing Address - Fax:606-679-1187
Practice Address - Street 1:402 BOGLE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2870
Practice Address - Country:US
Practice Address - Phone:606-679-1189
Practice Address - Fax:606-679-1187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY36456174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000247973OtherBLUE CROSS BLUE SHIELD
KYP00051848OtherRAILROAD MEDICARE
KY1197492OtherCHA
KY64051568Medicaid
KY203482OtherBLACK LUNG
KYP00051848OtherRAILROAD MEDICARE
KYH53378Medicare UPIN