Individual
SHANMUGAM MUKUNDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10401 W THUNDERBIRD BLVD, SUN CITY, AZ 85351-3004
(623) 876-5622
(623) 815-2931
Mailing address
10401 W THUNDERBIRD BLVD, SUN CITY, AZ 85351-3004
(623) 876-5622
(623) 815-2931
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101229163
VA
207R00000X
Internal Medicine Physician
Primary
37254
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010151431
—
VA
01
—
13965
ANTHEM
—
01
—
201020956
CIGNA
—
01
—
2128136
ALLIANCE
—
01
—
690545
NCPPO
—
01
—
8128136
OPTIMUM CHOICE
—
01
—
AETNA
201020956
—
01
—
G0157201
RAILROAD MEDICARE
—
01
—
K012
BLUECROSS CAREFIRST NCA
—
Enumeration date
08/12/2006
Last updated
08/31/2010
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