Individual
DR. MICHAEL SANFORD NALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9113 LEESGATE RD, LOUISVILLE, KY 40222-5003
(502) 426-1621
(502) 426-7906
Mailing address
9113 LEESGATE RD, LOUISVILLE, KY 40222-5003
(502) 426-1621
(502) 426-7906
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
14272
KY
207K00000X
Allergy & Immunology Physician
Primary
14272
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14272
KY LICENSE
KY
01
—
4012731
AETNA
KY
01
—
50025708
PASSPORT
KY
05
—
64142722
—
KY
Enumeration date
06/25/2009
Last updated
03/20/2015
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