Individual
MICHELLE THERESA ENGELHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1025 NEW MOODY LN, LA GRANGE, KY 40031-9154
(502) 222-8535
(502) 222-3932
Mailing address
5200 COMMERCE CROSSINGS DR FL 3, LOUISVILLE, KY 40229-2182
(502) 253-4924
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125053703
IL
207R00000X
Internal Medicine Physician
42622
KY
207R00000X
Internal Medicine Physician
57011470
OH
208M00000X
Hospitalist Physician
Primary
42622
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000652964
ANTHEM
KY
01
—
50026569
PASSPORT
KY
05
—
7100094770
—
KY
Enumeration date
05/24/2007
Last updated
12/11/2020
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