Mahan, Angela L

Mahan, Angela L is an individual health care provider with primary practice located at 4003 Kresge Way Ste 224 , Louisville KY 40207. She recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as her primary health care specialty. Mahan, Angela L can be contacted via phone (502) 895-2295.

Contact Information

Primary practice address
4003 Kresge Way Ste 224 Louisville KY 40207
Phone: (502) 895-2295
Fax: (502) 895-2296
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 44595 Kentucky

Profile Details

NPI number 1275670556
LBN Legal business name Mahan, Angela L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2007
Last updated Dec 8th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275670556 NPPES
Kentucky MEDICAID 7100243450

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