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General NPI Number Information
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NPI Number | 1609814623
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Entity Type | Individual
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Provider Name | STEPHEN ANVAR MD
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Gender | Male
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 4000 KRESGE WAY
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City | LOUISVILLE
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State | KY
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Zip | 40207-4605
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Country | US
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Telephone | 502-897-8121
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Fax |
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Provider Business Mailing Address
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Address Line | 702 EXECUTIVE PARK
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City | LOUISVILLE
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State | KY
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Zip | 40207-4207
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Country | US
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Telephone |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 01096584A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 37502
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License Number State | KY
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