Individual
VINCENT P TANAMACHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3101 POPLAR LEVEL RD STE 101, LOUISVILLE, KY 40213-1076
(502) 636-7444
(502) 636-7112
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28178
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000350822
ANTHEM - NMCA
—
01
—
000014952V
HUMANA / NCMA
KY
01
—
048229
SIHO / NCMA
KY
01
—
1184325
CHA / NCMA
KY
01
—
2446864000
PAD - NCMA
—
01
—
50005560
PASSPORT - NCMA
—
05
—
64281785
—
KY
01
—
7617604
CIGNA / NCMA
KY
01
—
P00193395
MEDICARE RAILROAD
KY
Enumeration date
04/18/2006
Last updated
04/12/2024
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