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NPI Code Detail

MEDICARE: MOHAMED ABDULKAF TASHANI MD

MEDICARE: MOHAMED ABDULKAF TASHANI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician28399WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14123516OTHERWVHIGHMARK BCBS

General Provider Information

NPI Number : 1093104028
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOHAMED ABDULKAF TASHANI MD
Provider Business Mailing Address
First Line : PO BOX 417
Second Line :
City : WHITE SULPHUR SPRINGS
State : WV
Zip : 24986-0417
Country : US
Telephone Number : 304-536-5030
Fax Number : 304-536-5031
Provider Business Practice Location Address
First Line : 1401 HARRODSBURG RD STE A120
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-3779
Country : US
Telephone Number : 859-258-6784
Fax Number : 859-258-6796
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2015
Last Update Date : 03/24/2022

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