Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 55550 | KY |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 55550 | KY |
NPI | 1053706119 |
---|---|
Provider Name | Lauren Fader |
First Address | Louisville, KY 40202-1622 |
Second Address | Louisville, KY 40202-3700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2015 |
Last Update Date | 23/08/2021 |