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MEENAPRATAP CHILUKURI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 778-3499
Mailing address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 778-3499

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
39389
KY
207R00000X
Internal Medicine Physician
Primary
39389
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64125503
KY
Enumeration date
01/27/2006
Last updated
03/31/2011
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