Healthcare Provider Details

I. General information

NPI: 1285291294
Provider Name (Legal Business Name): HIMA BINDU MUSUNURU MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2019
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 BABCOCK BLVD RM G762
PITTSBURGH PA
15237-5815
US

IV. Provider business mailing address

2516 ADELE CT
SEWICKLEY PA
15143-2525
US

V. Phone/Fax

Practice location:
  • Phone: 412-367-6454
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD481981
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: