Individual
KETAN RAMAKANT JHUNJHUNWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17 DAVIS BLVD STE 308, TAMPA, FL 33606-3438
(813) 974-2201
Mailing address
8 MEDICAL PARK, STE 420, NEUROLOGY DEPARTMENT, COLUMBIA, SC 29203
(803) 545-6050
(803) 545-6051
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
39939
SC
2084N0400X
Neurology Physician
LL39939
SC
208VP0014X
Interventional Pain Medicine Physician
39939
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
399394
—
SC
01
—
SCK3085019
MEDICARE PIN
SC
Enumeration date
07/28/2016
Last updated
06/18/2021
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