Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0129X | Vascular Surgeon | FL060 | KY |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | FL060 | KY |
NPI | 1003398207 |
---|---|
Provider Name | Dr. Siddharth Pahwa |
First Address | Louisville, KY 40201-0909 |
Second Address | Louisville, KY 40202-3841 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2018 |
Last Update Date | 07/12/2021 |