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Individual

ABHIJIT HALDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3920 DUTCHMANS LN, LOUISVILLE, KY 40207-4702
(502) 259-6710
(502) 259-6704
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01045964A
IN
207L00000X
Anesthesiology Physician
Primary
30389
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050070972
RAILROAD MEDICARE
KY
05
200245780
IN
05
64303894
KY
01
CH6488
RR MEDICARE GROUP NUMBER
KY
Enumeration date
10/03/2005
Last updated
04/26/2023
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