Individual
DR. MUKESH KUMAR MADUPUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2201 LEXINGTON AVE, ASHLAND, KY 41101-2843
(606) 408-7000
Mailing address
2754 SOLUTION CTR, CHICAGO, IL 60677-2007
(606) 408-6200
(606) 408-4775
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
38916
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2674422
—
OH
05
—
3810006434
—
WV
05
—
64092620
—
KY
Enumeration date
07/18/2006
Last updated
09/22/2015
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