Provider Demographics
NPI:1336101542
Name:DAHAR, IRFAN (MD)
Entity Type:Individual
Prefix:
First Name:IRFAN
Middle Name:
Last Name:DAHAR
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 1265
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040
Mailing Address - Country:US
Mailing Address - Phone:513-528-4000
Mailing Address - Fax:
Practice Address - Street 1:6730 ROOSEVELT AVE STE 201
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45005-5730
Practice Address - Country:US
Practice Address - Phone:513-279-0857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0764982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64033566Medicaid
OH2142149Medicaid
OH260047004OtherRAILROAD MEDICARE
OH0885209Medicare PIN
OH2142149Medicaid
OHG53421Medicare UPIN