Stidam, Jeffrey M.

Stidam, Jeffrey M. is an individual health care provider with primary practice located at 225 Abraham Flexner Way Suite 305, Louisville KY 40202-1882. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Stidam, Jeffrey M. can be contacted via phone (502) 585-4321.

Contact Information

Primary practice address
225 Abraham Flexner Way Suite 305 Louisville KY 40202-1882
Phone: (502) 585-4321
Fax: (502) 566-6338
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 01063360A Indiana
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 39017 Kentucky
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology 207RC0001X 01063360A Indiana
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology 207RC0001X 39017 Kentucky

Profile Details

NPI number 1063545275
LBN Legal business name Stidam, Jeffrey M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2007
Last updated Mar 21st, 2018 - about 7 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 1063545275 NPPES
Indiana MEDICAID 200856500
Indiana MEDICAID 7100069260

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