Individual
MS. PUSHPA R MUDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
45 HIGH ST, NASHUA, NH 03060-3312
(603) 821-7788
(603) 821-5620
Mailing address
45 HIGH ST, NASHUA, NH 03060-3312
(603) 821-7788
(603) 821-5620
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
14664
NH
207P00000X
Emergency Medicine Physician
48483
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110006287/A
—
MA
01
—
1528000890
ANTHEM BCBS NH
NH
05
—
30209531
—
NH
01
—
7051466
CIGNA
NH
01
—
P00892397
RAILROAD MEDICARE
NH
Enumeration date
06/12/2006
Last updated
10/06/2016
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