Individual
JABULANI MUNALULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
355 CRAWFORD ST, SUITE 300, PORTSMOUTH, VA 23704-2816
(757) 396-6333
(757) 396-6367
Mailing address
355 CRAWFORD ST, SUITE 102, PORTSMOUTH, VA 23704-2816
(757) 397-3400
(757) 399-0371
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101241103
VA
2086X0206X
Surgical Oncology Physician
Primary
0101241103
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0162448
GHI
—
01
—
10022031
OPTIMA
—
05
—
1437105467
—
VA
01
—
301730
ANTHEM BCBS
VA
05
—
5908181
—
NC
01
—
755184
AETNA
—
01
—
P00638801
MEDICARE RAILROAD
—
Enumeration date
05/25/2006
Last updated
12/16/2008
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