Individual
KUNAL K PATRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3549 SOUTHERN HILLS DR, SIOUX CITY, IA 51106-4736
(712) 274-6729
(712) 274-6744
Mailing address
PO BOX 5427, SIOUX CITY, IA 51102-5427
(712) 274-6729
(712) 274-6744
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35203
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0430702
—
IA
01
—
P00150357
MEDICARE ID UNSPECIFIED
—
Enumeration date
03/23/2006
Last updated
04/09/2008
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