Organization
LATA T. MUNDKUR MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PRAVIN VASUDEVA MUNDKUR (OFFICE MANAGER)
(978) 452-0672
Entity
Organization
Contact information
Practice address
817 MERRIMACK ST, LOWELL, MA 01854-3571
(978) 452-0672
Mailing address
817 MERRIMACK ST, LOWELL, MA 01854-3571
(978) 452-0672
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/05/2008
Last updated
01/05/2008
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