Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 47608 | KY |
NPI | 1144596164 |
---|---|
Provider Name | Dr. Neil Mahadev Patil |
First Address | Louisville, KY 40202-1434 |
Second Address | Louisville, KY 40202-3841 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2012 |
Last Update Date | 13/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100248520 (KOHMG) | (05) | KY |