Stavens, Christodulos Stefanatos

Stavens, Christodulos Stefanatos is an individual health care provider with primary practice located at 100 Mallard Creek Rd Suite 150, Louisville KY 40207-4194. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Stavens, Christodulos Stefanatos can be contacted via phone (502) 589-7907.

Contact Information

Primary practice address
100 Mallard Creek Rd Suite 150 Louisville KY 40207-4194
Phone: (502) 589-7907
Fax: (502) 589-1319
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 01035475A Indiana
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology 207RC0001X 24509 Kentucky
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 24509 Kentucky
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 24509 Kentucky

Profile Details

NPI number 1659457232
LBN Legal business name Stavens, Christodulos Stefanatos
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2006
Last updated Jun 14th, 2023 - about last year

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 1659457232 NPPES
Other 1052057 PASSPORT HEALTH PLAN
MEDICAID 64245095 PASSPORT HEALTH PLAN
Other 000000052133 PASSPORT HEALTH PLAN
Other 060052924 PASSPORT HEALTH PLAN
Other 060053877 PASSPORT HEALTH PLAN
Other 687915 PASSPORT HEALTH PLAN
MEDICAID 200040930 PASSPORT HEALTH PLAN
Other 25-00167 PASSPORT HEALTH PLAN
Other 299856 PASSPORT HEALTH PLAN
Other 415633P PASSPORT HEALTH PLAN
Other 060052921 PASSPORT HEALTH PLAN

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