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Individual

DIVYA B CANTOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 772-8189
Mailing address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 772-8189

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
30033
KY
207V00000X
Obstetrics & Gynecology Physician
G72946
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1051306
PASSPORT
KY
01
2623
BCBS
KY
05
64300338
KY
Enumeration date
08/11/2006
Last updated
01/22/2015
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