Healthcare Provider Details

I. General information

NPI: 1518138759
Provider Name (Legal Business Name): MUHAMMAD IRFAN ATIQ M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2008
Last Update Date: 02/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 HARRODSBURG RD STE C335
LEXINGTON KY
40504-1791
US

IV. Provider business mailing address

1401 HARRODSBURG RD STE C335
LEXINGTON KY
40504-1791
US

V. Phone/Fax

Practice location:
  • Phone: 859-276-5355
  • Fax: 859-277-1843
Mailing address:
  • Phone: 859-276-5355
  • Fax: 859-277-1843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number54483
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number48459
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: