Individual
MOHAMMAD K GAYASADDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
914 N DIXIE AVE, SUITE 301, ELIZABETHTOWN, KY 42701-2520
(270) 765-2220
(270) 765-2226
Mailing address
914 N DIXIE AVE, SUITE 301, ELIZABETHTOWN, KY 42701-2520
(270) 765-2220
(270) 765-2226
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
39269
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6409216600
—
KY
Enumeration date
08/26/2005
Last updated
01/12/2010
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