NPI 1083018634

Dwight Mielke

Practitioner Specialist Louisville, KY

Practice location

Address: 6801 Dixie Hwy Suite 136, Louisville, KY 40258-3913
Phone: (502) 933-4327

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence KY1058 (KY)

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Registry record

NPI: 1083018634
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Oct 2014
Record last updated: 10 Oct 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.