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General NPI Number Information
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NPI Number | 1962661967
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Entity Type | Organization
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Legal Business Name | MUNGARA AND ASSOCIATES
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Dates
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Enumeration Date | 06/04/2008
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 440B SAINT LUKES DR SUITE B
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City | MONTGOMERY
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State | AL
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Zip | 36117-7104
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Country | US
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Telephone | 334-356-8080
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Fax | 334-215-8999
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Provider Business Mailing Address
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Address Line | 1743 LAURELWOOD LN
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City | MONTGOMERY
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State | AL
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Zip | 36117-4743
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Country | US
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Telephone | 205-427-6159
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MAHIJA MUNGARA
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Credential | MD
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Telephone | 205-427-6159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25723
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License Number State | AL
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