Individual
DR. ALFONSO CERVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
315 E BROADWAY, LOUISVILLE, KY 40202-3700
(502) 629-2500
(502) 629-2055
Mailing address
315 E BROADWAY, LOUISVILLE, KY 40202-3700
(502) 629-2500
(502) 629-2055
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
35051
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000259565
ANTHEM
—
05
—
200441020
—
IN
01
—
50001586
PASSPORT
—
05
—
64063035
—
KY
01
—
P00023370
RAILROAD MEDICARE
—
Enumeration date
02/08/2006
Last updated
01/12/2021
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