Individual
DR. OMRAN RIAD ABUL-KHOUDOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, FACS, RVT
Contact information
Practice address
613 23RD ST STE 520, ASHLAND, KY 41101-2878
(606) 326-1675
(606) 326-1436
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 326-1675
(606) 326-1436
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
35.093617
OH
2086S0129X
Vascular Surgery Physician
Primary
40007
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000777096
ANTHEM BCBS
KY
05
—
2645436
—
OH
05
—
3810006163
—
WV
05
—
64062821
—
KY
01
—
7499265
AETNA
KY
Enumeration date
05/10/2006
Last updated
01/19/2024
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