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1033140587

NPI Code Detail

MEDICARE: DR. KAMALENDRA NATH MONDAL MD

MEDICARE: DR. KAMALENDRA NATH MONDAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	0101237954	VA
2	207R00000X	Internal Medicine Physician	22079	WV
3	207R00000X	Internal Medicine Physician	5619	SD
4	207P00000X	Emergency Medicine Physician	22079	WV
5	207P00000X	Emergency Medicine Physician	5619	SD
6	207P00000X	Emergency Medicine Physician	056590	GA
7	207P00000X	Emergency Medicine Physician	D64729	MD
8	207P00000X	Emergency Medicine Physician	104762	MO
9	207P00000X	Emergency Medicine Physician	0101237954	VA
10	207P00000X	Emergency Medicine Physician	MD00046396	WA
11	207R00000X	Internal Medicine Physician	D64729	MD
12	207R00000X	Internal Medicine Physician	056590	GA
13	207R00000X	Internal Medicine Physician	MD00046396	WA
14	207R00000X	Internal Medicine Physician	104762	MO

General Provider Information

NPI Number	:	1033140587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAMALENDRA NATH MONDAL MD

Provider Business Mailing Address
First Line	:	3149 AMBASSADOR CAFFERY PKWY
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70506-7209
Country	:	US
Telephone Number	:	337-706-3415
Fax Number	:

Provider Business Practice Location Address
First Line	:	3149 AMBASSADOR CAFFERY PKWY
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70506-7209
Country	:	US
Telephone Number	:	337-706-3415
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	02/29/2024

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Directions to “ DR. KAMALENDRA NATH MONDAL MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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