Individual
MRUTHYUNJAYA GONCHIGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
196 THOMAS JOHNSON DR, SUITE 215, FREDERICK, MD 21702-4397
(301) 668-9988
(301) 668-9977
Mailing address
196 THOMAS JOHNSON DR, SUITE 215, FREDERICK, MD 21702-4397
(301) 668-9988
(301) 668-9977
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
D0050726
MD
208VP0000X
Pain Medicine Physician
Primary
D0050726
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
697L395D
PAIN MANAGEMENT
MD
01
—
P00875961
MEDICARE RAILROAD
MD
Enumeration date
04/19/2006
Last updated
04/05/2012
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