Individual
DEEP AJMANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 E CHESTNUT ST, SERVICES BLDG, STE 303, LOUISVILLE, KY 40202-1831
(502) 629-5552
(502) 629-3132
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
36867
KY
208M00000X
Hospitalist Physician
01054037A
IN
208M00000X
Hospitalist Physician
Primary
36867
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000623994
ANTHEM - NICS
KY
01
—
000023036C
HUMANA - NICS
KY
01
—
053263
SIHO - NICS
KY
05
—
200539510
—
IN
01
—
3731183000
PASSPORT ADVANTAGE - NICS
KY
01
—
3933147
CIGNA - NICS
KY
01
—
50025232
PASSPORT - NICS
KY
05
—
64051717
—
KY
Enumeration date
08/31/2006
Last updated
04/17/2020
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