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NPI Code Detail

MEDICARE: MIDWEST GERIATRICS

MEDICARE: MIDWEST GERIATRICS
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
1363LF0000XFamily Nurse Practitioner
2363LG0600XGerontology Nurse PractitionerKY
3363LA2200XAdult Health Nurse PractitionerKY
4207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1942430855
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIDWEST GERIATRICS
Provider Business Mailing Address
First Line : PO BOX 43091
Second Line :
City : LOUISVILLE
State : KY
Zip : 40253-0091
Country : US
Telephone Number : 502-425-2507
Fax Number :
Provider Business Practice Location Address
First Line : 9700 STONESTREET RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40272-2884
Country : US
Telephone Number : 502-425-2507
Fax Number :
Authorized Official
Title or Position : PHYSICIAN/OWNER
Name : WAQAR SALEEM
Credential : M.D.
Telephone Number : 502-543-9124
Provider Enumeration Date : 07/27/2009
Last Update Date : 11/18/2024

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Directions to “MIDWEST GERIATRICS ” Practice Location

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