Healthcare Provider Details

I. General information

NPI: 1003896861
Provider Name (Legal Business Name): FERDOUSI BEGUM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 KATE IRELAND DR
HYDEN KY
41749
US

IV. Provider business mailing address

106 ARGYLL CIR
HAZARD KY
41701-8932
US

V. Phone/Fax

Practice location:
  • Phone: 606-672-2901
  • Fax: 606-672-3626
Mailing address:
  • Phone: 606-435-8157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number37217
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: