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General NPI Number Information
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NPI Number | 1841272721
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Entity Type | Individual
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Provider Name | SYED ABDUL KHADER DPM
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Gender | Male
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 07/15/2021
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Provider Practice Location Address
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Address Line | 3045 RING RD
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-7933
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Country | US
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Telephone | 270-737-3338
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Fax | 270-765-5666
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Provider Business Mailing Address
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Address Line | 4612 OUTER LOOP
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City | LOUISVILLE
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State | KY
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Zip | 40219-3971
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Country | US
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Telephone | 502-804-4811
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 07000994A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 07000994A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 243933
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License Number State | KY
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