Individual
DR. ELPIDIO DEJESUS PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2307 GREENE WAY, LOUISVILLE, KY 40220-4009
(502) 897-9594
Mailing address
2307 GREENE WAY, LOUISVILLE, KY 40220-4009
(502) 897-9594
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
36832
KY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
36832
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64039423
—
KY
Enumeration date
04/19/2006
Last updated
06/26/2014
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