MEDICARE: DR. MOHAMMAD AFZAL MIAN 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
1	174400000X	Specialist	22242	KY
2	174400000X	Specialist	01037543A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881796183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMAD AFZAL MIAN M.D.

Provider Business Mailing Address
First Line	:	8521 LA GRANGE RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40242-3800
Country	:	US
Telephone Number	:	502-817-0927
Fax Number	:	502-805-0690

Provider Business Practice Location Address
First Line	:	8521 LA GRANGE RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40242-3800
Country	:	US
Telephone Number	:	502-817-0927
Fax Number	:	502-805-0690

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2006
Last Update Date	:	12/03/2024

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