MEDICARE: DR. RAMA M KUNKLE DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	4698	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386845758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMA M KUNKLE DO

Provider Business Mailing Address
First Line	:	9225 N 3RD STREET
Second Line	:	300
City	:	PHOENIX
State	:	AZ
Zip	:	85020-2473
Country	:	US
Telephone Number	:	602-445-0751
Fax Number	:	602-424-8128

Provider Business Practice Location Address
First Line	:	9225 N 3RD STREET
Second Line	:	300
City	:	PHOENIX
State	:	AZ
Zip	:	85020-2473
Country	:	US
Telephone Number	:	602-445-0751
Fax Number	:	602-424-8128

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2007
Last Update Date	:	06/02/2016

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