Organization
COMMUNITY MEDICAL ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY GAST (CREDENTIALING)
(502) 272-5335
Entity
Organization
Contact information
Practice address
4803 OLYMPIA PARK PLZ STE 1100, LOUISVILLE, KY 40241-3068
(502) 584-7525
(502) 584-6851
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1117387
KY
Other
Enumeration date
08/05/2015
Last updated
09/21/2021
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