Individual
MANSOOR AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2130 LEXINGTON RD STE A-B, RICHMOND, KY 40475-7923
(859) 623-5500
(833) 249-5207
Mailing address
2130 LEXINGTON RD STE A-B, RICHMOND, KY 40475-7923
(859) 623-5500
(833) 249-5207
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
7100065040
KY
207RS0010X
Sports Medicine (Internal Medicine) Physician
40119
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000598642
ANTHEM INDIVIDUAL #
KY
05
—
7100065040
—
KY
01
—
786409
AETNA PIN#
—
Enumeration date
06/07/2006
Last updated
09/13/2022
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