# A.M. FAHEEM, M.D., P.S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932266947
- **Authorized official:** MR. AMJAD M FAHEEM MD (PRESIDENT)
- **Authorized official phone:** (270) 769-0892

## Contact information

- **Practice address:** 914 N DIXIE AVE, SUITE 302, ELIZABETHTOWN, KY 42701-2520
- **Practice address phone:** (270) 769-0892
- **Practice address fax:** (270) 769-1857
- **Mailing address:** 914 N DIXIE AVE, SUITE 302, ELIZABETHTOWN, KY 42701-2520
- **Mailing address phone:** (270) 769-0892
- **Mailing address fax:** (270) 769-1857

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | Yes |
| 174400000X | Specialist | — | — | Yes |

## Other

- **Enumeration date:** 01/02/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1055519 | ELIZABETHTOWN OFFICE PP\# | KY |
| 01 | — | 1055553 | RADCLIFF PASSPORT \# | KY |
| 01 | — | 1055554 | HODGENVILLE OFFICE PASS\# | KY |
| 05 | — | 65937468 | — | KY |
| 05 | — | 65937476 | — | KY |
| 05 | — | 65937492 | — | KY |