Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | RL14596 | ND |
N | 111NI0900X | Internist | RL14596 | ND |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 67008 | MN |
NPI | 1073039632 |
---|---|
Provider Name | Mayuri Mudgal |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2017 |
Last Update Date | 02/11/2021 |