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NPI Code Detail

MEDICARE: DR. AMJAD NISAR M.D.

MEDICARE: DR. AMJAD NISAR 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
12084P0800XPsychiatry Physician36385KY

General Provider Information

NPI Number : 1972597292
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMJAD NISAR M.D.
Provider Business Mailing Address
First Line : 115 ROCKWOOD LN
Second Line :
City : HAZARD
State : KY
Zip : 41701-9415
Country : US
Telephone Number : 606-436-5761
Fax Number : 606-436-5797
Provider Business Practice Location Address
First Line : 115 ROCKWOOD LN
Second Line :
City : HAZARD
State : KY
Zip : 41701-9415
Country : US
Telephone Number : 606-436-5761
Fax Number : 606-436-5797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2005
Last Update Date : 03/07/2023

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