Individual
DIBSON DIBE GONDIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202
(502) 852-6395
(502) 852-1761
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
11016567A
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
52231
KY
Other
Enumeration date
08/06/2012
Last updated
06/03/2019
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