Individual
MATHOGANDAPALLY S ARUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 WYNN DR NW, HUNTSVILLE, AL 35816-3445
(256) 890-8700
Mailing address
6416 OLD WINTER GARDEN RD, ORLANDO, FL 32835-1348
(407) 447-7121
(407) 770-0661
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD81599
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043690150
TAX ID
AL
01
—
51510737
BC PROVIDER NUMBER
AL
Enumeration date
05/22/2006
Last updated
02/27/2019
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