Individual
KEERTHANA DWARAKAN MUGUNDU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1514 VERNON RD, LAGRANGE, GA 30240-4131
(706) 812-2369
Mailing address
1514 VERNON RD, LAGRANGE, GA 30240-4131
(706) 812-2369
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
84428
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2016
Last updated
02/04/2020
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