Individual
TIMIR BANERJEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
220 ABRAHAM FLEXNER WAY STE 1200, LOUISVILLE, KY 40202
(502) 899-3623
(502) 899-7970
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
20052
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000381968
ANTHEM-NICC
KY
01
—
035861
SIHO / NICC
KY
05
—
100006949
—
IN
05
—
64200520
—
KY
01
—
P00362319
RAILROAD MEDICARE
IN
01
—
P00362322
RAILROAD MEDICARE
KY
Enumeration date
04/19/2006
Last updated
03/11/2019
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