Organization
ALBERTO RENE MALDONADO, M.D., P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALBERTO RENE MALDONADO M.D. (PRESIDENT)
(502) 456-9214
Entity
Organization
Contact information
Practice address
1169 EASTERN PKWY, SUITE 3337, LOUISVILLE, KY 40217-1417
(502) 456-9214
(502) 458-9348
Mailing address
1169 EASTERN PKWY, SUITE 3337, LOUISVILLE, KY 40217-1417
(502) 456-9214
(502) 458-9348
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
21106
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000049333
ANTHEM
KY
01
—
100014410A
MEDICAID OF INDIANA
KY
01
—
1049929
PASSPORT HEALTH PLAN
KY
01
—
240007602
PALMETTOGBA
KY
01
—
2432718000
PASSPORT ADVANTAGE
KY
05
—
64211063
—
KY
01
—
K005255
CHAMPUS
KY
Enumeration date
03/10/2010
Last updated
03/10/2010
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