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NPI Code Detail

MEDICARE: ROBIN B BIDEAU M.D.

MEDICARE:   ROBIN B BIDEAU  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician31981KY

Other Identifiers

General Provider Information

NPI Number : 1013910678
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBIN B BIDEAU M.D.
Provider Business Mailing Address
First Line : 2307 GREENE WAY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40220-4009
Country : US
Telephone Number : 502-736-4343
Fax Number :
Provider Business Practice Location Address
First Line : 2307 GREENE WAY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40220-4009
Country : US
Telephone Number : 502-897-9594
Fax Number : 502-736-4456
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 11/01/2016

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