Organization
A.M. FAHEEM, M.D., P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AMJAD M FAHEEM MD (PRESIDENT)
(270) 769-0892
Entity
Organization
Contact information
Practice address
914 N DIXIE AVE, SUITE 302, ELIZABETHTOWN, KY 42701-2520
(270) 769-0892
(270) 769-1857
Mailing address
914 N DIXIE AVE, SUITE 302, ELIZABETHTOWN, KY 42701-2520
(270) 769-0892
(270) 769-1857
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1055519
ELIZABETHTOWN OFFICE PP#
KY
01
—
1055553
RADCLIFF PASSPORT #
KY
01
—
1055554
HODGENVILLE OFFICE PASS#
KY
05
—
65937468
—
KY
05
—
65937476
—
KY
05
—
65937492
—
KY
Enumeration date
01/02/2007
Last updated
08/22/2020
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