Individual
SURYA BOOPATHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 ZORN AVE, LOUISVILLE, KY 40206-1433
(502) 287-6143
Mailing address
800 ZORN AVE, LOUISVILLE, KY 40206-1433
(502) 287-6143
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
56318
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689137234
NPI
—
Enumeration date
04/10/2019
Last updated
08/30/2024
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