Provider Demographics
NPI:1538114418
Name:SABHARWAL, KAILASH C (MD)
Entity Type:Individual
Prefix:
First Name:KAILASH
Middle Name:C
Last Name:SABHARWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KAILASH
Other - Middle Name:C
Other - Last Name:SAHARWAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 950202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0202
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:2355 POPLAR LEVEL RD STE 301
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1388
Practice Address - Country:US
Practice Address - Phone:502-636-5532
Practice Address - Fax:502-636-5137
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY16601207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000614191OtherANTHEM NMA
KY057234OtherSIHO - NMA
KY1049985Medicaid
KYP00634901OtherMEDICARE RAILROAD - NMA
KY00533066OtherMEDICARE - NMA
KY0433951OtherCIGNA - NMA
KY50020500OtherPASSPORT - NMA
KY000023033TOtherHUMANA - NMA
KY3538758000OtherPASSPORT ADVTG - NMA
IN200035810Medicaid
KY3759067000OtherPASSPORT ADVTG - NCMA
KY50027049OtherPASSPORT - NCMA
KY64166010Medicaid
KY1279702Medicare PIN
KY50027049OtherPASSPORT - NCMA
KY3759067000OtherPASSPORT ADVTG - NCMA