Healthcare Provider Details

I. General information

NPI: 1679136196
Provider Name (Legal Business Name): IMAMA AHMAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2019
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST STE 301
LEXINGTON KY
40536-7001
US

IV. Provider business mailing address

800 ROSE ST
LEXINGTON KY
40536-7001
US

V. Phone/Fax

Practice location:
  • Phone: 859-218-5350
  • Fax:
Mailing address:
  • Phone: 859-323-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number61423
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number61423
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number61423
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number61423
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: