Individual
MOHAN KRISHNA TUMMALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2055 S FREMONT AVE, SUITE 100, SPRINGFIELD, MO 65804-2206
(417) 820-8099
(417) 820-8093
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
2011016083
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174667109
—
MO
Enumeration date
02/15/2007
Last updated
10/03/2014
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