Provider Demographics
NPI:1740330398
Name:ARAR, GHIAS MOHAMAD (MD)
Entity type:Individual
Prefix:
First Name:GHIAS
Middle Name:MOHAMAD
Last Name:ARAR
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 23568
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-0568
Mailing Address - Country:US
Mailing Address - Phone:502-254-4014
Mailing Address - Fax:502-254-4015
Practice Address - Street 1:13806 LAKE POINT CIR
Practice Address - Street 2:SUITE 101
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-4222
Practice Address - Country:US
Practice Address - Phone:502-254-4014
Practice Address - Fax:502-254-4015
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY324112084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2435739000OtherPASSPORT ADVANTAGE GROUP
2442006000OtherPASSPORT ADVANTAGE
50000296OtherPASSPORT
000000052175OtherANTHEM BCBS
5853602OtherAETNA
KY64324114Medicaid
0500150OtherUNITED HEALTHCARE
130019966OtherRR MEDICARE
000000052175OtherANTHEM BCBS
5853602OtherAETNA
KY64324114Medicaid