Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | 51853 | KY |
NPI | 1326493461 |
---|---|
Provider Name | Panambur Laxminaraya Bhandari |
First Address | Louisville, KY 40202 |
Second Address | Louisville, KY 40202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2016 |
Last Update Date | 03/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100581730 | (05) | KY |