Healthcare Provider Details

I. General information

NPI: 1417973793
Provider Name (Legal Business Name): TAUSIF SAYIED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4003 KRESGE WAY STE 312
LOUISVILLE KY
40207-4652
US

IV. Provider business mailing address

4003 KRESGE WAY SUITE 312
LOUISVILLE KY
40207-4652
US

V. Phone/Fax

Practice location:
  • Phone: 502-899-7377
  • Fax: 502-899-5832
Mailing address:
  • Phone: 502-899-7377
  • Fax: 502-899-5832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number34070
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number34070
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number34070
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: