Individual
MANTAVYA PUNJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9605 SANDIFUR PKWY, PASCO, WA 99301-8028
(509) 942-3170
(509) 543-9795
Mailing address
550 GAGE BLVD STE 101, RICHLAND, WA 99352-9532
(509) 946-4611
(509) 627-2983
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD61357479
WA
207Q00000X
Family Medicine Physician
TRN29309
FL
207QS1201X
Sleep Medicine (Family Medicine) Physician
MD61357479
WA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
ME154593
FL
Other
Enumeration date
06/15/2019
Last updated
07/14/2023
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