Healthcare Provider Details

I. General information

NPI: 1609458918
Provider Name (Legal Business Name): MUHAMMAD FAHAD KHALID MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2021
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-7001
US

IV. Provider business mailing address

1350 EAST MARKET STREET, 7TH FLOOR
WARREN OH
44483
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-6047
  • Fax: 859-257-3873
Mailing address:
  • Phone: 330-841-9647
  • Fax: 330-841-9645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number59993
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: