Healthcare Provider Details

I. General information

NPI: 1407841117
Provider Name (Legal Business Name): MUJTABA F TAPAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 05/24/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 STATE ROUTE 261
NEWBURGH IN
47630-2764
US

IV. Provider business mailing address

4211 STATE ROUTE 261
NEWBURGH IN
47630-2764
US

V. Phone/Fax

Practice location:
  • Phone: 812-962-7353
  • Fax: 270-685-1874
Mailing address:
  • Phone: 812-962-7353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01059296A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number01059296A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: