| Medicine Pllc | |
|
15103 Chestnut Ridge Cir Louisville KY 40245-5291 | |
| (502) 742-9149 | |
| (502) 896-7292 |
| Full Name | Medicine Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 15103 Chestnut Ridge Cir, Louisville, Kentucky |
| Authorized Official Name and Position | Jawed Nasim (PRESIDENT) |
| Authorized Official Contact | 5027429149 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medicine Pllc Po Box 890853 Charlotte NC 28289-0853 Ph: (800) 605-5176 | Medicine Pllc 15103 Chestnut Ridge Cir Louisville KY 40245-5291 Ph: (502) 742-9149 |
| NPI Number | 1003003351 |
|---|---|
| Provider Enumeration Date | 10/01/2007 |
| Last Update Date | 01/06/2017 |
| Medicare PECOS PAC ID | 1658460092 |
|---|---|
| Medicare Enrollment ID | O20071207000565 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003003351 | NPI | - | NPPES |
| 6435287500 | Medicaid | KY | |
| 200906410A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Jawed Nasim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871576702 PECOS PAC ID: 9436055795 Enrollment ID: I20031209000414 |
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