Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 2012016173 | MO |
Y | 207L00000X | Anesthesiologist | MD-44792 | IA |
NPI | 1013265990 |
---|---|
Provider Name | Dr. Chaitra Mukundan |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2012 |
Last Update Date | 17/03/2018 |