Individual
SUFIAN AHMAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
151 DREXLER CIR STE 1, ELIZABETHTOWN, KY 42701-7843
(270) 506-2730
(270) 900-0704
Mailing address
151 DREXLER CIR STE 1, ELIZABETHTOWN, KY 42701-7843
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
48695
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100250610
—
KY
Enumeration date
06/25/2012
Last updated
04/20/2016
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