Individual
PEDRO SAGMIT BAULA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
596 WESTPORT RD, SUITE NO 101, ELIZABETHTOWN, KY 42701
(270) 769-6888
(270) 769-9199
Mailing address
596 WESTPORT RD, SUITE NO 101, ELIZABETHTOWN, KY 42701
(270) 769-6888
(270) 769-9199
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
32415
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1110487
PASSPORT
KY
05
—
64324155
—
KY
Enumeration date
11/13/2006
Last updated
07/09/2007
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