Healthcare Provider Details

I. General information

NPI: 1033372313
Provider Name (Legal Business Name): AINHOA COSTAS CHAVARRI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 04/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 ABRAHAM FLEXNER WAY SUITE 850
LOUISVILLE KY
40202-1882
US

IV. Provider business mailing address

225 ABRAHAM FLEXNER WAY SUITE 850
LOUISVILLE KY
40202-1882
US

V. Phone/Fax

Practice location:
  • Phone: 502-562-0312
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036.117041
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number42807
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: