Individual
DR. ROBERTO FERNANDO CHULLUNCUY RIVAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 E CHESTNUT ST UNIT 510, LOUISVILLE, KY 40202-5710
(502) 588-4800
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
60597
KY
2084V0102X
Vascular Neurology Physician
Primary
60597
KY
390200000X
Student in an Organized Health Care Education/Training Program
57.249752
OH
Other
Enumeration date
07/31/2020
Last updated
05/06/2025
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