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General NPI Number Information
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NPI Number | 1023372034
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Entity Type | Individual
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Provider Name | INDU ELIZABETH MATHEW MD
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Gender | Female
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Dates
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Enumeration Date | 06/25/2012
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Last Update Date | 07/06/2015
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Provider Practice Location Address
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Address Line | UNIVERSITY OF KENTUCKY 800 ROSE STREET
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City | LEXINGTON
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State | KY
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Zip | 40536-0293
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Country | US
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Telephone | 859-323-1786
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Fax | 859-257-1078
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Provider Business Mailing Address
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Address Line | 1188 LACY LN
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City | LEXINGTON
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State | KY
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Zip | 40513-1900
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Country | US
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Telephone | 412-953-0201
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | TP403
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License Number State | KY
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