Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 1074898A | IN |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 22795 | WV |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | TP160 | KY |
NPI | 1073703369 |
---|---|
Provider Name | Dr. Ahmad Aftab Khan |
First Address | Louisville, KY 40295-0248 |
Second Address | Louisville, KY 40207-4660 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2007 |
Last Update Date | 07/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1942385950 | GROUP MEDICAID (01) | WV |
3810010862 | (05) | WV |
9154261 | GROUP MEDICARE (01) | WV |