MANOOCHER MOFIDI MD NPI 1013934959

NPI Information

NPI: 1013934959
Provider Name: MANOOCHER MOFIDI, MD
Classification: Psychiatry & Neurology - 2084P0804X
Entity Type: Individual

Specialization: Child & Adolescent Psychiatry

Address:
2225 W BROADWAY
LOUISVILLE, KY
ZIP 40211
Phone: (502) 589-8600
Get Directions

Manoocher Mofidi, MD is a child and adolescent psychiatry psychiatry neurology in Louisville, KY. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. Manoocher Mofidi, MD NPI is 1013934959. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2225 W BROADWAY
LOUISVILLE, KY
ZIP 40211-003
Phone: (502) 589-8600
Fax: (502) 589-8771

The enumeration date for this NPI number is 7/16/2006 and was last updated on 2/13/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0800X	Psychiatry & Neurology	Psychiatry	01037544A	INDIANA	No
2	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	25630	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	E39163	MEDICARE UPIN
2	200189820A	MEDICAID	INDIANA
3	084270A	MEDICARE ID-TYPE UNSPECIFIED	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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