Healthcare Provider Details

I. General information

NPI: 1578827630
Provider Name (Legal Business Name): AHMAD RAMY ELASHERY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2012
Last Update Date: 06/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S LIMESTONE ST CTW 326
LEXINGTON KY
40536-5805
US

IV. Provider business mailing address

900 SOUTH LIMESTONE ST. , CT WETHINGTON BUILDING
LEXINGTON KY
40503-0200
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-8040
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number51658
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: