Healthcare Provider Details

I. General information

NPI: 1154320414
Provider Name (Legal Business Name): JHULAN MUKHARJI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 09/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9119 W 74TH ST SUITE 350
SHAWNEE MISSION KS
66204-2215
US

IV. Provider business mailing address

9119 W 74TH ST SUITE 350
SHAWNEE MISSION KS
66204-2215
US

V. Phone/Fax

Practice location:
  • Phone: 913-789-3290
  • Fax: 913-789-3208
Mailing address:
  • Phone: 913-789-3290
  • Fax: 913-789-3208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMDR7G88
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: