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General NPI Number Information
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NPI Number | 1548459449
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Entity Type | Individual
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Provider Name | AREBU TAHIR ABDU MD
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Gender | Male
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 12/13/2021
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Provider Practice Location Address
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Address Line | 800 ROSE ST # MS -477
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City | LEXINGTON
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State | KY
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Zip | 40536-0298
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Country | US
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Telephone | 895-323-5361
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Fax |
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Provider Business Mailing Address
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Address Line | 712 STATESMAN WAY
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City | LEXINGTON
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State | KY
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Zip | 40505-4076
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Country | US
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Telephone | 859-368-0302
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 40865
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License Number State | KY
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