1538114418 NPI number — KAILASH C SABHARWAL MD

Table of content: KAILASH C SABHARWAL MD (NPI 1538114418)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538114418 NPI number — KAILASH C SABHARWAL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SABHARWAL
Provider First Name:
KAILASH
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SAHARWAL
Provider Other First Name:
KAILASH
Provider Other Middle Name:
C
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1538114418
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/10/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 950202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40295-0202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-588-9490
Provider Business Mailing Address Fax Number:
502-272-5116

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2355 POPLAR LEVEL RD STE 301
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40217-1388
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-636-5532
Provider Business Practice Location Address Fax Number:
502-636-5137
Provider Enumeration Date:
05/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X , with the licence number:  16601 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000614191 . This is a "ANTHEM NMA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 057234 . This is a "SIHO - NMA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1049985 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00634901 . This is a "MEDICARE RAILROAD - NMA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 00533066 . This is a "MEDICARE - NMA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 0433951 . This is a "CIGNA - NMA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50020500 . This is a "PASSPORT - NMA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000023033T . This is a "HUMANA - NMA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 3538758000 . This is a "PASSPORT ADVTG - NMA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 200035810 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3759067000 . This is a "PASSPORT ADVTG - NCMA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50027049 . This is a "PASSPORT - NCMA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 64166010 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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