Individual
MONALISA MOHAN TAILOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
825 BARRET AVE, LOUISVILLE, KY 40204-1743
(502) 540-7200
(502) 540-7210
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
45916
KY
207R00000X
Internal Medicine Physician
R2388
KY
207R00000X
Internal Medicine Physician
TRN15210
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100173490
—
KY
Enumeration date
06/14/2010
Last updated
01/22/2021
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