Individual
NITIN N WADHWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4123 DUTCHMANS LN STE 301, LOUISVILLE, KY 40207-4721
(502) 896-2500
(502) 896-2527
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 899-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
39290
KY
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
39290
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000805260
ANTHEM -KCNS
KY
01
—
145059
SIHO - KCNS
KY
05
—
201160960
—
IN
01
—
50049164
PASSPORT - KCNS
KY
05
—
7000033820
—
KY
Enumeration date
04/25/2007
Last updated
01/22/2021
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