Individual
DR. ANDREW M DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13328 SHELBYVILLE RD, LOUISVILLE, KY 40223-3936
(502) 254-2223
(502) 254-2525
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01047227A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200153740A
—
IN
05
—
300047045
—
IN
01
—
351708493
TAX ID#
IN
05
—
7100071770
—
KY
Enumeration date
09/26/2005
Last updated
04/24/2024
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