MEDICARE: KAMAL K. NIGAM MD INTERNAL MEDICINE, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	32515	KY

General Provider Information

NPI Number	:	1194966135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAMAL K. NIGAM MD INTERNAL MEDICINE, PLLC

Provider Business Mailing Address
First Line	:	804 DORSEY LN
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40223-2609
Country	:	US
Telephone Number	:	502-384-1499
Fax Number	:	502-384-1499

Provider Business Practice Location Address
First Line	:	804 DORSEY LN
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40223-2609
Country	:	US
Telephone Number	:	502-384-1499
Fax Number	:	502-384-1499

Authorized Official
Title or Position	:	SOLE PROPRIETER
Name	:	DR. KAMAL KANT NIGAM
Credential	:	MD
Telephone Number	:	502-938-1799

Provider Enumeration Date	:	03/22/2009
Last Update Date	:	03/22/2009

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