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Individual

MR. IBRAHIM FAHSAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
201 ABRAHAM FLEXNER WAY STE 903, LOUISVILLE, KY 40202-3832
(502) 916-1055
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 916-1055

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
32990
KY
207R00000X
Internal Medicine Physician
32990
KY
207RC0000X
Cardiovascular Disease Physician
32990
KY
207RI0011X
Interventional Cardiology Physician
Primary
32990
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000057094O
HUMANA- CTS
KY
01
108285
ANTHEM- CTS
KY
05
200122110
IN
01
353176400
PASSPORT ADVANTAGE
KY
01
50019752
PASSPORT
KY
01
50031678
PASSPORT- CARDIOTHORACIC SURGERY OF LOUISVILLE
KY
01
5151604
AETNA- CTS
KY
05
64329907
KY
01
P00468647
RAILROAD MEDICARE
KY
01
P00924103
RAILROAD MEDICARE- CTS
KY
Enumeration date
06/07/2006
Last updated
05/22/2023
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