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General NPI Number Information
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NPI Number | 1912151374
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Entity Type | Individual
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Provider Name | SHAISTA TARIQ ARAIN M.D
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Gender | Female
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Dates
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Enumeration Date | 11/12/2008
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Last Update Date | 06/05/2014
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Provider Practice Location Address
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Address Line | 740 S LIMESTONEST KENTUCKY CLINIC J-403
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City | LEXINGTON
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State | KY
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Zip | 40536-0001
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Country | US
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Telephone | 859-323-6211
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Fax |
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Provider Business Mailing Address
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Address Line | 202 BARTRAM CT
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City | WINCHESTER
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State | KY
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Zip | 40391-9340
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Country | US
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Telephone | 859-403-0069
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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 | 43523
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License Number State | KY
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