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General NPI Number Information
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NPI Number | 1215931969
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Entity Type | Organization
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Legal Business Name | KUMAR MUKERJEE MD INC
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 03/13/2014
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Provider Practice Location Address
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Address Line | 25 W HARDING RD
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City | SPRINGFIELD
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State | OH
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Zip | 45504-1341
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Country | US
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Telephone | 937-399-0453
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Fax | 937-399-2847
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Provider Business Mailing Address
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Address Line | 25 W HARDING RD
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City | SPRINGFIELD
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State | OH
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Zip | 45504-1341
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Country | US
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Telephone | 937-399-0453
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Fax | 937-399-2847
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Authorized Official
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Title or Position | OWNER
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Name | DR. KUMAR MUKERJEE
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Credential | MD
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Telephone | 937-399-0453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35035615M
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License Number State | OH
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