Doctor Name: | TIMIR BANERJEE |
NPI Number: | 1730144189 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 01028862A |
Business Practice Address: | 7926 Preston Hwy Ste 106 Louisville, KY - 402193848 |
Business Phone Number: | 5029644357 |
Business Fax Number: | 5029665948 |
Mailing Address: | Po Box 950202, LOUISVILLE |
State: | KY |
Postal Code: | 402950202 |
Phone Number: | 5025889490 |
Fax Number: | 5022725116 |
NPI Enumeration Date: | 04/19/2006 |
NPI Last Update Date: | 11/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 01028862A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |