Basic Information
Provider Information
NPI: 1093275075
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DHAHRI
FirstName: AMINA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 ROSE ST STE CC-402
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405360093
CountryCode: US
TelephoneNumber: 8592574488
FaxNumber: 8592573531
Practice Location
Address1: 800 ROSE ST STE CC-402
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405360093
CountryCode: US
TelephoneNumber: 8592574488
FaxNumber: 8592570093
Other Information
ProviderEnumerationDate: 03/25/2019
LastUpdateDate: 08/24/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/24/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207R00000X56330KYY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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