Healthcare Provider Details

I. General information

NPI: 1750567103
Provider Name (Legal Business Name): USHA KUNDU MD FACOG PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2008
Last Update Date: 04/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 N DAVIS HWY SUITE 1
PENSACOLA FL
32503-2064
US

IV. Provider business mailing address

5500 N DAVIS HWY SUITE 1 1
PENSACOLA FL
32503-2064
US

V. Phone/Fax

Practice location:
  • Phone: 850-476-9802
  • Fax: 850-476-9841
Mailing address:
  • Phone: 850-476-9802
  • Fax: 850-476-9841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME38199
License Number StateFL

VIII. Authorized Official

Name: DR. USHA KUNDU
Title or Position: DOCTOR
Credential: M.D
Phone: 850-476-9802