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General NPI Number Information
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NPI Number | 1942430855
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Entity Type | Organization
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Legal Business Name | MIDWEST GERIATRICS
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 9700 STONESTREET RD
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City | LOUISVILLE
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State | KY
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Zip | 40272-2884
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Country | US
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Telephone | 502-425-2507
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 43091
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City | LOUISVILLE
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State | KY
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Zip | 40253-0091
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Country | US
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Telephone | 502-425-2507
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | WAQAR SALEEM
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Credential | M.D.
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Telephone | 502-543-9124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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