Provider Demographics
NPI:1962988535
Name:KHANAL, LUNA (MD)
Entity type:Individual
Prefix:
First Name:LUNA
Middle Name:
Last Name:KHANAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 MOONBOW PLZ
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-8949
Mailing Address - Country:US
Mailing Address - Phone:606-523-9010
Mailing Address - Fax:606-523-0028
Practice Address - Street 1:45 MOONBOW PLZ
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-8949
Practice Address - Country:US
Practice Address - Phone:606-523-9010
Practice Address - Fax:606-523-0028
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-17
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY58698207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease