Provider Demographics
NPI:1053380410
Name:NIAZI, MUHAMMAD A (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:A
Last Name:NIAZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:520 TECHWOOD DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-8500
Mailing Address - Country:US
Mailing Address - Phone:859-936-9844
Mailing Address - Fax:859-236-0320
Practice Address - Street 1:165 LONDON MOUNTAIN VIEW DRIVE
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741
Practice Address - Country:US
Practice Address - Phone:606-330-7900
Practice Address - Fax:606-330-7905
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY35550207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY87094OtherCOVENTRYCARES OF KENTUCKY
KY61-1277847OtherHUMANA
KY61-1277847OtherTRICARE
KY000000479073OtherANTHEM BC/BS
KYP00316080OtherRAILROAD MEDICARE
KY61-1277847OtherUNITED HEALTH CARE
KY2789232000OtherPASSPORT
KY1255007OtherAETNA
KY64029044Medicaid
KYC24047OtherCUMBERLAND HEALTH CARE
KY61-1277847OtherUNITED HEALTH CARE
KY1255007OtherAETNA
KYC24047OtherCUMBERLAND HEALTH CARE
KYP00316080OtherRAILROAD MEDICARE
KY64029044Medicaid
KY87094OtherCOVENTRYCARES OF KENTUCKY
KY0546612Medicare PIN