MEDICARE: DR. ADRIAN ANTHONY MAUNG 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	208600000X	Surgery Physician	216850	MA
2	2086S0127X	Trauma Surgery Physician	046427	CT

General Provider Information

NPI Number	:	1043292147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADRIAN ANTHONY MAUNG MD

Provider Business Mailing Address
First Line	:	330 CEDAR ST # BB310
Second Line	:	YALE UNIVERSITY SCHOOL OF MEDICINE SECTION OF TRAUMA
City	:	NEW HAVEN
State	:	CT
Zip	:	06510-3218
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 CEDAR ST # BB310
Second Line	:	YALE UNIVERSITY SCHOOL OF MEDICINE SECTION OF TRAUMA
City	:	NEW HAVEN
State	:	CT
Zip	:	06510-3218
Country	:	US
Telephone Number	:	203-785-3494
Fax Number	:

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

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	05/27/2008

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