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NPI Code Detail

MEDICARE: MICHAEL J IMBURGIA MD

MEDICARE: MICHAEL J IMBURGIA MD
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
1207RC0000XCardiovascular Disease Physician26431KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649278938
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL J IMBURGIA MD
Provider Business Mailing Address
First Line : 310 E BROADWAY STE 100
Second Line :
City : LOUISVILLE
State : KY
Zip : 40202-1745
Country : US
Telephone Number : 502-245-0002
Fax Number : 502-742-0485
Provider Business Practice Location Address
First Line : 310 E BROADWAY STE 100
Second Line :
City : LOUISVILLE
State : KY
Zip : 40202-1745
Country : US
Telephone Number : 502-245-0002
Fax Number : 502-742-0485
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2005
Last Update Date : 03/07/2023

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