Individual
CHAMUNDAMBIKA SHANMUGAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
520 S VAN BUREN RD, SUITE 2, EDEN, NC 27288-5042
(336) 635-6809
(336) 635-6862
Mailing address
PO BOX 488, EDEN, NC 27289-0488
(336) 635-6809
(336) 627-0778
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036114856
IL
208000000X
Pediatrics Physician
Primary
2012-01298
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036114856
—
IL
01
—
174NH
NC BLUE CROSS BLUE SHIELD
NC
05
—
5921210
—
NC
Enumeration date
03/23/2006
Last updated
06/13/2025
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