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Individual

CINDY J CODE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3950 KRESGE WAY, SUITE 303, LOUISVILLE, KY 40207
(502) 896-1880
(502) 896-1887
Mailing address
2600 STANLEY GAULT PARKWAY, SUITE 201, LOUISVILLE, KY 40223
(502) 238-2801
(502) 238-2835

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
40855
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3529187000
PASSPORT ADVANTAGE
KY
01
50019697
PASSPORT
KY
05
7100052040
KY
Enumeration date
06/19/2008
Last updated
11/19/2009
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