Individual
SEAN WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
215 CENTRAL AVE STE 100, LOUISVILLE, KY 40208
(502) 588-8720
(502) 588-8721
Mailing address
2700 STANLEY GAULT PKWY STE 129, LOUISVILLE, KY 40223-5176
(502) 253-4900
(502) 489-5751
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
51617
KY
207Q00000X
Family Medicine Physician
TP690
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100429320
—
KY
Enumeration date
04/15/2015
Last updated
12/10/2020
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