Organization
CUMBERLAND CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SATYABRATA CHATTERJEE MD (MANAGING MEMBER)
(606) 864-4040
Entity
Organization
Contact information
Practice address
1210 W 5TH ST, LONDON, KY 40741-2112
(606) 864-4040
(606) 877-1722
Mailing address
PO BOX 1300, LONDON, KY 40743-1300
(606) 864-4040
(606) 864-3500
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000503391
BCBS OF KY
KY
01
—
612029800
FEDERAL BLACK LUNG GROUP NUMBER
—
05
—
7100020740
—
KY
Enumeration date
10/18/2006
Last updated
04/23/2008
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