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Individual

DR. SRINIVASAN MUKUNDAN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
75 FRANCIS ST, BRIGHAM AND WOMEN'S HOSPITAL, BOSTON, MA 02115-6110
(617) 732-7260
Mailing address
75 FRANCIS ST, BRIGHAM AND WOMEN'S HOSPITAL, BOSTON, MA 02115-6110
(617) 732-7260

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
236798
MA
2085R0202X
Diagnostic Radiology Physician
Primary
236798
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110081546/A
MA
05
891315T
NC
Enumeration date
10/05/2006
Last updated
09/24/2012
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