Individual
VIPUL R PANCHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6420 DUTCHMANS PKWY, SUITE 200, LOUISVILLE, KY 40205-3372
(502) 891-8300
(502) 891-8338
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
37828
KY
207RI0011X
Interventional Cardiology Physician
37828
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000293982
ANTHEM PIN
KY
01
—
000000693044
ANTHEM- CARDIOTHORACIC SURGERY OF LOUISVILLE
KY
01
—
000057080O
HUMANA- CARDIOTHORACIC SURGERY OF LOUISVILLE
KY
05
—
200423290A
—
IN
05
—
200423290F
—
IN
01
—
2209313000
PASSPORT ADVANTAGE PIN
KY
01
—
50000940
PASSPORT PIN
KY
01
—
50031168
PASSPORT- CTS
KY
05
—
64064785
—
KY
01
—
P00893031
RAILROAD MEDICARE- CTS
KY
Enumeration date
06/21/2006
Last updated
10/18/2019
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