Provider Demographics
NPI:1447258553
Name:MOVANIA, JAWED M (MD)
Entity type:Individual
Prefix:MR
First Name:JAWED
Middle Name:M
Last Name:MOVANIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1321 RING RD
Mailing Address - Street 2:STE 105
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-8940
Mailing Address - Country:US
Mailing Address - Phone:270-986-7373
Mailing Address - Fax:270-351-5499
Practice Address - Street 1:700 W LINCOLN TRAIL BLVD
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-2604
Practice Address - Country:US
Practice Address - Phone:270-351-3192
Practice Address - Fax:270-351-5499
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY31578207R00000X, 207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64315781Medicaid
KY64315781Medicaid
KYG23434Medicare UPIN