Healthcare Provider Details

I. General information

NPI: 1275722183
Provider Name (Legal Business Name): SUMA K SARAFF MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2007
Last Update Date: 11/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 HARRODSBURG RD SUITE B-395
LEXINGTON KY
40504-3751
US

IV. Provider business mailing address

PO BOX 911065
LEXINGTON KY
40591-1065
US

V. Phone/Fax

Practice location:
  • Phone: 859-278-1982
  • Fax: 859-278-0095
Mailing address:
  • Phone: 859-278-1982
  • Fax: 859-278-0095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. SUMA K SARAFF
Title or Position: PRESIDENT
Credential: MD
Phone: 859-278-1982