Healthcare Provider Details

I. General information

NPI: 1063626653
Provider Name (Legal Business Name): UMAIR AHMAD GAUHAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 01/23/2020
Certification Date: 01/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 S JACKSON ST # A3R40 UNIVERSITY OF LOUISVILLE, DIVISION OF PULMONARY MED
LOUISVILLE KY
40202-1622
US

IV. Provider business mailing address

550 S. JACKSON STREET, ACB A3R40 UNIVERSITY OF LOUISVILLE, DIVISION OF PULMONARY
LOUISVILLE KY
40202
US

V. Phone/Fax

Practice location:
  • Phone: 502-852-5841
  • Fax: 502-852-1359
Mailing address:
  • Phone: 502-852-5841
  • Fax: 502-852-1359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number45537
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35.097668
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: