Healthcare Provider Details

I. General information

NPI: 1598743361
Provider Name (Legal Business Name): RASHID FAIYAZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 04/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 STATE ST
NEW ALBANY IN
47150-4990
US

IV. Provider business mailing address

800 HIGHLANDER POINT DR SUITE 204
FLOYDS KNOBS IN
47119-9465
US

V. Phone/Fax

Practice location:
  • Phone: 812-944-7701
  • Fax: 812-981-6505
Mailing address:
  • Phone: 812-542-4921
  • Fax: 812-949-5966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number01062019A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number35078839
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number36526
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: