Healthcare Provider Details

I. General information

NPI: 1740237072
Provider Name (Legal Business Name): NORA UMALI SESSOMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 BLUEGRASS AVE
LOUISVILLE KY
40215-1161
US

IV. Provider business mailing address

100 E LIBERTY ST STE 800
LOUISVILLE KY
40202-1428
US

V. Phone/Fax

Practice location:
  • Phone: 502-361-6617
  • Fax: 502-361-6637
Mailing address:
  • Phone: 502-361-6617
  • Fax: 502-361-6637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number21967
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: