Individual
DR. CHRISTOPHER J. HAVELDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 PLEASANT VALLEY RD, SUITE 202, OWENSBORO, KY 42303-9774
(270) 417-7500
(270) 417-7509
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 688-1330
(270) 688-1338
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
18921
KY
207RI0011X
Interventional Cardiology Physician
01027600A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000051226
ANTHEM BCBS
KY
01
—
000000605847
COOP HEALTH ANTHEM #
KY
05
—
200010210A
—
IN
05
—
64189210
—
KY
Enumeration date
08/19/2006
Last updated
03/02/2015
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