Individual
SRINIVAS M AMMISETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9350 US HWY 23 SOUTH, SUITE 104, STANVILLE, KY 41659
(606) 478-1005
(606) 478-8687
Mailing address
9350 US HWY 23 SOUTH, P O BOX 70, STANVILLE, KY 41659
(606) 478-1005
(606) 478-8687
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
35594
KY
207RS0012X
Sleep Medicine (Internal Medicine) Physician
35594
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65943516
—
KY
Enumeration date
10/25/2006
Last updated
04/07/2020
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