Individual
KAMAKSHI K MUKKAVILLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7227 E BASELINE RD STE 126, MESA, AZ 85209-5006
(480) 868-9650
(480) 834-3606
Mailing address
7227 E BASELINE RD STE 126, MESA, AZ 85209-5006
(480) 868-9650
(480) 834-3606
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29911
AZ
207R00000X
Internal Medicine Physician
ME134144
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
ME134144
FL
Other
Enumeration date
03/23/2007
Last updated
02/26/2020
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