Provider Demographics
NPI:1912916024
Name:QUADRI, SYED R (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:R
Last Name:QUADRI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1321 RING RD
Mailing Address - Street 2:STE 105
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-8940
Mailing Address - Country:US
Mailing Address - Phone:270-986-7373
Mailing Address - Fax:270-769-1857
Practice Address - Street 1:1311 RING RD
Practice Address - Street 2:STE 105
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-8941
Practice Address - Country:US
Practice Address - Phone:270-769-0892
Practice Address - Fax:270-769-1857
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2017-04-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY34388207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64014152Medicaid
000000519677OtherANTHEM
KY7066070OtherAETNA
KY7066070OtherAETNA
KY00252001Medicare PIN