Stavens, Gerasimos S
Stavens, Gerasimos S is an individual health care provider with primary practice located at 100 Mallard Creek Rd Suite 150, Louisville KY 40207-4194. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Stavens, Gerasimos S 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:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | 38382 | Kentucky |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 38382 | Kentucky |
Profile Details
| NPI number | 1255464236 |
|---|---|
| LBN Legal business name | Stavens, Gerasimos S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 13th, 2007 |
| Last updated | Oct 27th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255464236 | NPPES |
| Kentucky | Other | 060052921 | RAILROAD MEDICARE |
| Kentucky | MEDICAID | 200198560A | RAILROAD MEDICARE |
| Kentucky | MEDICAID | 201275370 | RAILROAD MEDICARE |
| Kentucky | Other | 000000909758 | RAILROAD MEDICARE |
| Kentucky | MEDICAID | 7100326390 | RAILROAD MEDICARE |
| Kentucky | Other | P01433982 | RAILROAD MEDICARE |
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