Individual
ABBAS ALI KHAWARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 AUDUBON PLAZA DR, LOUISVILLE, KY 40217-1318
(502) 742-7062
Mailing address
PO BOX 950137, LOUISVILLE, KY 40295-0137
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1066082A
IN
207R00000X
Internal Medicine Physician
Primary
40695
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000814741
ANTHEM
KY
05
—
200970750
—
IN
01
—
50102205
PASSPORT HEALTH PLAN
KY
05
—
7100025260
—
KY
01
—
P01601393
RAILROAD MEDICARE
KY
Enumeration date
09/04/2007
Last updated
02/13/2020
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