Individual
MICHAEL JOSEPH ELDEMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8442 DIXIE HWY, LOUISVILLE, KY 40258-1140
(502) 638-4280
(502) 638-4281
Mailing address
2112 DOUGLASS BLVD, LOUISVILLE, KY 40205-1902
(502) 638-4280
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01053566A
IN
207Q00000X
Family Medicine Physician
Primary
41336
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200291520
—
IN
05
—
7100037280
—
KY
Enumeration date
04/18/2006
Last updated
09/09/2013
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