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Individual

ALALEH ESMAEILI SHANDIZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 852-1816
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
11017834A
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
TP169
KY

Other

Enumeration date
06/21/2014
Last updated
05/08/2020
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