Provider Demographics
NPI:1396168308
Name:HOSPITAL MEDICINE ASSOCIATES, PLLC
Entity type:Organization
Organization Name:HOSPITAL MEDICINE ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:JAWAID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-572-0515
Mailing Address - Street 1:5407 MERRIBROOK LN
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-7620
Mailing Address - Country:US
Mailing Address - Phone:502-572-0515
Mailing Address - Fax:
Practice Address - Street 1:5407 MERRIBROOK LN
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-7620
Practice Address - Country:US
Practice Address - Phone:502-572-0515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty