Healthcare Provider Details

I. General information

NPI: 1326278342
Provider Name (Legal Business Name): SAMIR RAMESHCHANDRA KARIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2009
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S FLOYD ST STE 500
LOUISVILLE KY
40202-1837
US

IV. Provider business mailing address

PO BOX 909
LOUISVILLE KY
40201-0909
US

V. Phone/Fax

Practice location:
  • Phone: 502-589-8033
  • Fax: 502-588-2339
Mailing address:
  • Phone: 502-588-3050
  • Fax: 502-588-0785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4301082663
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number33113
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberTP268
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: