Individual
BOKHODIR S MAMEDOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3950 KRESGE WAY STE 308, LOUISVILLE, KY 40207-4637
(502) 851-3268
Mailing address
3950 KRESGE WAY STE 308, LOUISVILLE, KY 40207-4637
(502) 895-8911
(502) 895-8977
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
54999
KY
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/28/2017
Last updated
06/11/2021
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