Individual
SONAL D MAJMUNDAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2403 LOY DR, LAFAYETTE, IN 47909-2701
(765) 448-8000
(765) 448-8335
Mailing address
250 N SHADELAND AVENUE, SUITE 130, INDIANAPOLIS, IN 46219-4959
(317) 963-0860
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
02002221A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000184378
ANTHEM PROVIDER NUMBER
IN
01
—
11485478
CAQH NUMBER
IN
05
—
200298090
—
IN
01
—
9274781
PHCS PID NUMBER
IN
Enumeration date
03/15/2006
Last updated
04/24/2015
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