Provider Demographics
NPI:1972737849
Name:HAMOUDA, RASHA SALAH (MD)
Entity type:Individual
Prefix:
First Name:RASHA
Middle Name:SALAH
Last Name:HAMOUDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 CREEKCROSSING DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-5510
Mailing Address - Country:US
Mailing Address - Phone:301-760-8533
Mailing Address - Fax:
Practice Address - Street 1:103 S CHARTER RD APT F
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3161
Practice Address - Country:US
Practice Address - Phone:301-760-8533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY45538207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300006487Medicaid
KYP01207504OtherRAILROAD MEDICARE
KYP01890808OtherRR MEDICARE (KOHMG)
KYK052355OtherKY MEDICARE (KOHMG)