1922169465 NPI number — NADEEM A TALPUR M.D.

Table of content: NADEEM A TALPUR M.D. (NPI 1922169465)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922169465 NPI number — NADEEM A TALPUR M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TALPUR
Provider First Name:
NADEEM
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922169465
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 776351
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60677-6351
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:
210 E GRAY ST
Provider Second Line Business Practice Location Address:
STE 1003
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202-3906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-629-2602
Provider Business Practice Location Address Fax Number:
502-629-2603
Provider Enumeration Date:
12/12/2006

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: 2084N0400X , with the licence number:  42665 , 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: 50030757 . This is a "PASSPORT/PASSPORT ADVTG - NNS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000057058D . This is a "HUMANA - NNS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 7100072690 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 201040800 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 119125 . This is a "SIHO - NNS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 3160546 . This is a "CIGNA - NNS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000693360 . This is a "ANTHEM - NNS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: P00893051 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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