Individual
STEPHEN KYLE DREISBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6400 DUTCHMANS PKWY, SUITE 300, LOUISVILLE, KY 40205-3340
(502) 894-2444
(502) 894-2445
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
43072
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000623621
ANTHEM
KY
01
—
000000712995
ANTHEM - NCMA
KY
01
—
000057120F
HUMANA - NCMA
KY
01
—
125976
SIHO - NCMA
KY
01
—
3723485000
PASSPORT ADVANTAGE
KY
01
—
50024602
PASSPORT
KY
01
—
50033196
PASSPORT/PASSPORT ADV - NCMA
KY
01
—
5360772
CIGNA - NCMA
KY
05
—
7100085660
—
KY
Enumeration date
03/21/2007
Last updated
03/22/2024
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