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Individual

BAHRAM FOROUZANDEH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5000 KY ROUTE 321, PRESTONSBURG, KY 41653-9113
(606) 886-7645
(606) 889-6206
Mailing address
5000 KY ROUTE 321, PRESTONSBURG, KY 41653-9113
(606) 886-7645
(606) 889-6206

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
31205
KY
207RG0100X
Gastroenterology Physician
Primary
31205
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000323512
ANTHEM BC/BS PIN NUMBER
KY
01
1097430
PASSPORT HEALTH PIN #
KY
01
1171556
CHA HEALTH PIN NUMBER
KY
01
1541974
UMWA PIN NUMBER
KY
01
5274306
AETNA PIN NUMBER
KY
01
6000540000
WV MEDICAID PIN NUMBER
KY
01
607181400
FEDERAL BLACK LUNG PIN #
KY
05
64312051
KY
01
P00098815
RAILROAD MEDICARE PIN #
KY
Enumeration date
02/22/2006
Last updated
08/24/2023
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