Midwest Infectious Disease Pllc | |
6301 Glen Hill Rd Louisville KY 40222-6026 | |
(502) 380-5658 | |
Not Available |
Full Name | Midwest Infectious Disease Pllc |
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Speciality | Internal Medicine |
Location | 6301 Glen Hill Rd, Louisville, Kentucky |
Authorized Official Name and Position | Khaled Jouja (OWNER) |
Authorized Official Contact | 5023805658 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Midwest Infectious Disease Pllc Po Box 221646 Louisville KY 40252-1646 Ph: (502) 380-5658 | Midwest Infectious Disease Pllc 6301 Glen Hill Rd Louisville KY 40222-6026 Ph: (502) 380-5658 |
NPI Number | 1093919250 |
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Provider Enumeration Date | 06/12/2007 |
Last Update Date | 11/19/2009 |
Medicare PECOS PAC ID | 0042305708 |
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Medicare Enrollment ID | O20070926001105 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093919250 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
Provider Name | Khaled Jouja |
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Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1548240369 PECOS PAC ID: 5092808634 Enrollment ID: I20070912000473 |
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