# DR. SULABHA S. MUJUMDAR

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1669553731
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 19968 | KY | Yes |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 08/02/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000047394 | BLUE CROSS | KY |
| 01 | — | 0033734 | BLUE CARE/TN CARE SELECT | TN |
| 05 | — | 006234241 | — | VA |
| 01 | — | 1307695 | UMWA | KY |
| 01 | — | 2196 | CHA | KY |
| 01 | — | 3195877 | TN MEDICAID | TN |
| 05 | — | 64199680 | — | KY |
| 01 | — | K04395 | CHAMPUS | KY |