Basic Information
| Provider Information | |||||||||
| NPI: | 1851486278 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AWASTHI | ||||||||
| FirstName: | MUKTA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 138 LEADER AVE | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405083215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592577910 | ||||||||
| FaxNumber: | 8592577899 | ||||||||
| Practice Location | |||||||||
| Address1: | 740 SOUTH LIMESTONE ST | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405360284 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593230303 | ||||||||
| FaxNumber: | 8592578675 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 09/17/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 40220 | KY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 40220 | KY | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.