Individual
DR. SAMER RIDA KALAKISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 PARK ST, BOWLING GREEN, KY 42101-1759
(270) 781-5111
(270) 780-0498
Mailing address
201 PARK ST, BOWLING GREEN, KY 42101-1759
(270) 781-5111
(270) 780-0498
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
121876
NC
208800000X
Urology Physician
Primary
42866
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000627329
ANTHEM
KY
05
—
7100085210
—
KY
01
—
P00793920
MEDICARE RAILROAD
KY
Enumeration date
12/21/2007
Last updated
07/02/2014
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