Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | 04-37029 | KS |
Y | 207RN0300X | Nephrologist | TP737 | KY |
NPI | 1013151968 |
---|---|
Provider Name | Dr. Rafael Baracaldo |
First Address | Louisville, KY 40205-3354 |
Second Address | Louisville, KY 40205-3354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2009 |
Last Update Date | 21/12/2020 |