Individual
ANGELES MICHELLE BUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4123 DUTCHMANS LN, SUITE 601, LOUISVILLE, KY 40207-4707
(502) 423-9595
(502) 719-0161
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
03118
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000724271
ANTHEM -WS
KY
01
—
0000571200
HUMANA - WS
KY
01
—
03118
STATE LICENSE
KY
01
—
127009
SIHO - WS
KY
05
—
201040620
—
IN
01
—
2668570
CIGNA-WS
KY
01
—
50034479
PASSPORT - WS
KY
05
—
7100060270
—
KY
Enumeration date
03/12/2007
Last updated
03/07/2023
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