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Individual

AJITH NAIR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3710 CHAMBERLAIN LN, STE A, LOUISVILLE, KY 40241
(502) 995-4004
(502) 933-5559
Mailing address
PO BOX 24261, LOUISVILLE, KY 40224-0261
(502) 995-4004
(502) 933-5559

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36217
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1073515227
MEDICARE NPI
KY
05
64024896
KY
Enumeration date
06/01/2005
Last updated
07/02/2018
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