Individual
BAKULA S SHETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 TREVILIAN WAY, LOUISVILLE, KY 40213-1545
(502) 473-8704
Mailing address
1001 TREVILIAN WAY, LOUISVILLE, KY 40213-1545
(502) 473-8704
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22084
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64220841
—
KY
Enumeration date
09/25/2006
Last updated
06/29/2012
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