Doctor Name: | CLARA PRADA COMER |
NPI Number: | 1205044070 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 18584 |
Business Practice Address: | 6105 Regal Springs Dr Louisville, KY - 402053323 |
Business Phone Number: | 5025526121 |
Business Fax Number: | |
Mailing Address: | 6105 Regal Springs Dr, LOUISVILLE |
State: | KY |
Postal Code: | 402053323 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/17/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 18584 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |