Individual
GARY C VITALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 E CHESTNUT ST, STE 710, LOUISVILLE, KY 40202-5700
(502) 583-8303
(502) 584-0302
Mailing address
401 E CHESTNUT ST, STE 710, LOUISVILLE, KY 40202-5700
(502) 583-8303
(502) 584-0302
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20934
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100344390A
—
IN
01
—
1051082
PASSPORT
KY
05
—
64209349
—
KY
Enumeration date
01/12/2006
Last updated
08/20/2009
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