Individual
DR. BAHRAM SEPEHRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
230 E BROADWAY, LOUISVILLE, KY 40202-2026
(502) 629-8990
(502) 394-3604
Mailing address
1425 STATE ST, SUITE 100, NEW ALBANY, IN 47150-4909
(812) 945-2229
(812) 949-2229
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01030087A
IN
208000000X
Pediatrics Physician
Primary
20885
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100115780A
—
IN
01
—
351708493
TAX ID#
IN
05
—
64208853
—
KY
Enumeration date
09/26/2005
Last updated
11/22/2021
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