Individual
ANDREW PAUL THALIATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4915 NORTON HEALTHCARE BLVD STE 301, LOUISVILLE, KY 40241-2866
(502) 394-6460
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 559-9425
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125073740
IL
2084N0400X
Neurology Physician
125073740
IL
2084N0400X
Neurology Physician
Primary
58868
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100984380
—
KY
Enumeration date
06/03/2019
Last updated
08/05/2024
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