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Individual

ACHAMMA S ITTICHERIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
828 LANE ALLEN RD STE 219, LEXINGTON, KY 40504
(502) 498-4071
(888) 423-5216
Mailing address
PO BOX 3299, CARSON CITY, NV 89702-3299
(775) 222-0044
(888) 700-0187

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44836
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100263350
KY
Enumeration date
05/14/2007
Last updated
02/26/2020
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