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Individual

HISHAM A ALREFAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9720 PARK PLAZA AVE UNIT 104, LOUISVILLE, KY 40241-2289
(502) 895-8218
(502) 895-8219
Mailing address
9720 PARK PLAZA AVE UNIT 104, LOUISVILLE, KY 40241-2289
(502) 895-8218
(502) 895-8219

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01055359A
IN
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
37214
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000831435
ANTHEM - NCMA
KY
01
149327
SIHO - NCMA
KY
05
200385521
IN
01
50053026
PASSPORT - NCMA
MA
05
64055395
KY
01
940540SSSS
LEGACY MEDICARE
IN
Enumeration date
02/20/2006
Last updated
02/09/2024
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