Individual
HAWA J EDRISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1401 HARRODSBURG RD STE A300, LEXINGTON, KY 40504
(859) 313-4744
(859) 276-5939
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
51370
KY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
51370
KY
207RP1001X
Pulmonary Disease Physician
Primary
51370
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/30/2012
Last updated
08/09/2019
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