Individual
FABIOLA MIHAELA ANDREI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 E CHESTNUT ST, SVC BLD SUITE 303, LOUISVILLE, KY 40202-1831
(502) 629-5552
(502) 629-3132
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1910
KY
363A00000X
Physician Assistant
TC327
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100327280
—
KY
01
—
PA1910
LICENSE
KY
Enumeration date
10/09/2014
Last updated
03/20/2024
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