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Individual

HICHAM TARIK ABADA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
800 ROSE ST, HX319D, LEXINGTON, KY 40536-0293
(859) 323-5069
(859) 257-4457
Mailing address
800 ROSE ST, HX319D, LEXINGTON, KY 40536-0293
(859) 323-5069
(859) 257-4457

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
FL032
KY
2085R0202X
Diagnostic Radiology Physician
SP182
IA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
FL032
KY
2085R0204X
Vascular & Interventional Radiology Physician
SP182
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0730085
IA
01
23004
WELLMARK BCBS
IA
05
7100094330
KY
Enumeration date
08/30/2006
Last updated
12/06/2012
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