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NPI Code Detail

MEDICARE: DR. HANAN NAFITZ BUDEIRI M.D.

MEDICARE:  DR. HANAN NAFITZ BUDEIRI  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician33601KY
2207R00000XInternal Medicine Physician33601KY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
35771OTHERKYMEDICARE GROUP NUMBER

Other Identifiers

General Provider Information

NPI Number : 1013962653
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HANAN NAFITZ BUDEIRI M.D.
Provider Business Mailing Address
First Line : 5200 COMMERCE CROSSINGS DR FL 3
Second Line :
City : LOUISVILLE
State : KY
Zip : 40229-2182
Country : US
Telephone Number : 502-253-4900
Fax Number : 502-489-5751
Provider Business Practice Location Address
First Line : 801 EASTERN BYP
Second Line :
City : RICHMOND
State : KY
Zip : 40475-2751
Country : US
Telephone Number : 859-625-3603
Fax Number : 859-625-3757
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2006
Last Update Date : 01/14/2020

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