Individual
DR. SUMIT MUKHERJEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 EDMUNDSON PL, STE. 306, COUNCIL BLUFFS, IA 51503-4658
(712) 396-7787
(712) 396-4115
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
2012014712
MO
207RP1001X
Pulmonary Disease Physician
Primary
MD-41368
IA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026209700
—
NE
05
—
1154647568
—
IA
Enumeration date
04/09/2010
Last updated
08/19/2016
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