Individual
DR. SVITLANA J MANDZY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4003 KRESGE WAY, SUITE 410, LOUISVILLE, KY 40207-4652
(502) 893-7462
(502) 212-7551
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 253-4900
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
36466
KY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
36466
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000197267
ANTHEM BC/BS
KY
05
—
1155612
—
KY
01
—
1750375861
RAILROAD MEDICARE
KY
01
—
6109684127217
ANTHEM SR. ADVANTAGE
KY
05
—
64046345
—
KY
Enumeration date
09/02/2005
Last updated
05/31/2017
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