Individual
VINCENT A MUKKADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3333 BURNET AVE, ML 2010, CINCINNATI, OH 45229-3026
(513) 636-4415
(513) 636-7805
Mailing address
3333 BURNET AVE, ML 2010, CINCINNATI, OH 45229-3026
(513) 636-4415
(513) 636-7805
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
35.120432
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD13019
LICENSE
RI
Enumeration date
10/27/2006
Last updated
02/01/2013
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