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JEFFREY M. STIDAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
225 ABRAHAM FLEXNER WAY, SUITE 305, LOUISVILLE, KY 40202-1882
(502) 585-4321
(502) 566-6338
Mailing address
100 E LIBERTY ST STE 800, LOUISVILLE, KY 40202-1428
(502) 585-4321
(502) 566-6338

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01063360A
IN
207RC0000X
Cardiovascular Disease Physician
39017
KY
207RC0001X
Clinical Cardiac Electrophysiology Physician
01063360A
IN
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
39017
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200856500
IN
05
7100069260
KY
Enumeration date
03/14/2007
Last updated
03/21/2018
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