Provider Demographics
NPI:1194966135
Name:KAMAL K. NIGAM MD INTERNAL MEDICINE, PLLC
Entity type:Organization
Organization Name:KAMAL K. NIGAM MD INTERNAL MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMAL
Authorized Official - Middle Name:KANT
Authorized Official - Last Name:NIGAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-938-1799
Mailing Address - Street 1:804 DORSEY LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2609
Mailing Address - Country:US
Mailing Address - Phone:502-384-1499
Mailing Address - Fax:502-384-1499
Practice Address - Street 1:804 DORSEY LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-2609
Practice Address - Country:US
Practice Address - Phone:502-384-1499
Practice Address - Fax:502-384-1499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-22
Last Update Date:2009-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY32515207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty