Individual
KULANGARA PUNNEN ZACHARIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 E 5TH STREET, FULTON STATE HOSPITAL, FULTON, MO 65251
(573) 592-4100
(573) 592-3023
Mailing address
600 E 5TH ST, FULTON, MO 65251-1753
(573) 592-4100
(573) 592-3023
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
R5547
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201789500
—
MO
Enumeration date
08/10/2006
Last updated
07/06/2017
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