Individual
SOFYA KUZNETSOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6420 DUTCHMANS PKWY STE 200, LOUISVILLE, KY 40205-3373
(502) 891-8300
(502) 891-8388
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 272-5337
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.057550
IL
207R00000X
Internal Medicine Physician
51423
KY
207RC0000X
Cardiovascular Disease Physician
51423
KY
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
51423
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300017096
—
IN
05
—
7100539310
—
KY
Enumeration date
10/20/2009
Last updated
10/23/2020
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