Moodumane, Indira

Moodumane, Indira is an individual health care provider with primary practice located at 809 Meyers Baker Rd Suite 1, London KY 40741-3025. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Other Service Providers / Specialist. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Moodumane, Indira can be contacted via phone (606) 864-7337.

Contact Information

Primary practice address
809 Meyers Baker Rd Suite 1 London KY 40741-3025
Phone: (606) 864-7337
Fax: (606) 878-3257
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 36054 Kentucky
Other Service Providers / Specialist 174400000X 36054 Kentucky

Profile Details

NPI number 1639181340
LBN Legal business name Moodumane, Indira
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2006
Last updated Oct 23rd, 2019 - 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 1639181340 NPPES
Kentucky MEDICAID 64039019

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