Provider Demographics
NPI:1487879599
Name:RAFIUDDIN, MUHAMMAD (MD)
Entity type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:
Last Name:RAFIUDDIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MUHAMMAD
Other - Middle Name:
Other - Last Name:RAFI UD DIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 6018
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41022-6018
Mailing Address - Country:US
Mailing Address - Phone:859-912-7716
Mailing Address - Fax:859-757-4923
Practice Address - Street 1:6909 BURLINGTON PIKE STE B
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1618
Practice Address - Country:US
Practice Address - Phone:859-912-7716
Practice Address - Fax:859-757-4923
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP143207RA0000X
KY40822207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200871890Medicaid
KY200871890OtherMD WISE- NORTON
KY50015466OtherPASSPORT- NORTON
KY089945OtherSIHO- NORTON
KY000023027WOtherHUMANA- NORTON
KY2853837000OtherPASSPORT ADVANTAGE- NORT.
KY1901496OtherCIGNA- NORTON
KY7100009440Medicaid
KYP00439736OtherRAILROAD MEDICARE-NORTON
KY7100009440Medicaid
KYK010702Medicare PIN