# DR. AVI MAZUMDAR

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1760547889
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084N0400X | Neurology Physician | 2002021169 | MO | — |
| 2085N0700X | Neuroradiology Physician | 036113885 | IL | — |
| 2085R0202X | Diagnostic Radiology Physician | 036113885 | IL | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | 036113885 | IL | Yes |

## Other

- **Enumeration date:** 12/27/2006
- **Last updated:** 01/22/2018