Individual
MUKUND KOMANDURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11360 BROADWAY, CROWN POINT, IN 46307-7197
(219) 600-4656
(877) 319-1709
Mailing address
11360 BROADWAY, CROWN POINT, IN 46307-7197
(219) 600-4656
(877) 319-1709
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01081064A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300023946
—
IN
Enumeration date
06/27/2006
Last updated
10/05/2023
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