Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 41863 | KY |
N | 2080P0210X | Pediatric Nephrologist | TP843 | KY |
NPI | 1619144474 |
---|---|
Provider Name | Aftab Shakir Chishti |
First Address | Lexington, KY 40517-4012 |
Second Address | Lexington, KY 40536-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2008 |
Last Update Date | 10/08/2015 |