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Individual

AMBICA MANJUNATH TUMKUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4915 NORTON HEALTHCARE BLVD STE 301, LOUISVILLE, KY 40241-2866
(502) 394-6460
(502) 394-6465
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6879
(502) 558-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
ME123581
FL
2084N0600X
Clinical Neurophysiology Physician
Primary
50099
KY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
015381600
FL
01
150NE
BLUE CROSS BLUE SHIELD
FL
05
7100481060
KY
Enumeration date
04/11/2010
Last updated
03/12/2026
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