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Individual

ANIL K MUNGARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3601 SW 160TH AVE, SUITE 250, MIRAMAR, FL 33027-6308
(954) 399-4621
(877) 892-9770
Mailing address
5727 ROSINWEED LN, NAPERVILLE, IL 60564-1635
(773) 213-7370

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01069767A
IN
208600000X
Surgery Physician
01069767A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4888861
MI
01
5315025419
CONTROLLED SUBSTANCE
Enumeration date
07/10/2006
Last updated
09/21/2011
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