Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 28861 | KY |
N | 207QA0505X | Family Doctor - Adult Medicine | 28861 | KY |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 28861 | KY |
N | 207QS0010X | Family Doctor - Sports Medicine | 28861 | KY |
NPI | 1518902840 |
---|---|
Provider Name | Sylvia Lee Cerel-Suhl |
First Address | Lexington, KY 40503-2457 |
Second Address | Lexington, KY 40503-2457 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2006 |
Last Update Date | 27/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64288616 | (05) | KY |
G37713 | (02) |