Organization
M&M MEDICAL CLINICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VENKAT SHARMA (CEO)
(502) 530-0916
Entity
Organization
Contact information
Practice address
240 MASONIC HOME DR, MASONIC HOME, KY 40041-9000
(502) 530-0916
(502) 719-1124
Mailing address
500 W JEFFERSON ST STE 2310, LOUISVILLE, KY 40202-2823
(502) 530-0916
(502) 719-1124
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
261QP1100X
Podiatric Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
01/11/2018
Last updated
12/23/2019
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