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Individual

KELLY M MCMASTERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
401 E CHESTNUT ST, SUITE 710, LOUISVILLE, KY 40202-5700
(502) 583-8303
(502) 584-0302
Mailing address
401 E CHESTNUT ST, SUITE 710, LOUISVILLE, KY 40202-5700
(502) 583-8303
(502) 584-0302

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
27332
KY
2086X0206X
Surgical Oncology Physician
Primary
27332
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1051087
PASSPORT
KY
05
200070640A
IN
05
64273329
KY
Enumeration date
01/12/2006
Last updated
07/30/2009
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