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Individual

FAIYAD YASEER MANNAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
727 HOSPITAL DR, SHELBYVILLE, KY 40065-1660
(502) 367-3360
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 367-3360

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
TP856
KY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100681900
KY
Enumeration date
03/22/2019
Last updated
11/07/2023
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