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Individual

MAZHAR SALIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1 TRILLIUM WAY, CORBIN, KY 40701-8426
(606) 523-8779
(606) 523-8721
Mailing address
2700 STANLEY GAULT PKWY STE 129, LOUISVILLE, KY 40223-5176
(502) 253-4900
(502) 489-5751

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
19331
MS
2084P0800X
Psychiatry Physician
Primary
40049
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64129554
KY
01
K142481
MEDICARE PTAN
KY
01
P01458484
RR MEDICARE
KY
Enumeration date
12/05/2006
Last updated
12/01/2020
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