Healthcare Provider Details

I. General information

NPI: 1821355322
Provider Name (Legal Business Name): NACHIKET MADHAV APTE M.B.B.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2012
Last Update Date: 08/11/2020
Certification Date: 08/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 ABRAHAM FLEXNER WAY STE 1001
LOUISVILLE KY
40202-3841
US

IV. Provider business mailing address

PO BOX 909
LOUISVILLE KY
40201-0909
US

V. Phone/Fax

Practice location:
  • Phone: 502-587-4384
  • Fax: 502-587-4184
Mailing address:
  • Phone: 502-587-4384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP27585
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number53783
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: