Individual
DR. CHARAN MUNGARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
353 FAIRMONT BLVD, MONUMENT HEALTH RAPID CITY HOSPITAL, RAPID CITY, SD 57701-7375
(205) 441-9459
(605) 755-0707
Mailing address
353 FAIRMONT BLVD, MONUMENT HEALTH RAPID CITY HOSPITAL, RAPID CITY, SD 57701-7375
(205) 441-9459
(605) 755-0707
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
11971
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000727503
ANTHEM PROVIDER NUMBER
IN
05
—
1649423872
—
WI
05
—
201029750
—
IN
Enumeration date
10/31/2008
Last updated
08/11/2020
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