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NPI Code Detail

MEDICARE: DR. BINU JAMES KUNJUMMEN M.D.

MEDICARE: DR. BINU JAMES KUNJUMMEN M.D.
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
1207RC0000XCardiovascular Disease Physician065135GA
2207RI0011XInterventional Cardiology Physician065135GA

Other Identifiers

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

General Provider Information

NPI Number : 1437331196
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BINU JAMES KUNJUMMEN M.D.
Provider Business Mailing Address
First Line : 1468 MONTREAL RD
Second Line :
City : TUCKER
State : GA
Zip : 30084-6901
Country : US
Telephone Number : 770-638-1400
Fax Number : 770-638-1411
Provider Business Practice Location Address
First Line : 1468 MONTREAL RD
Second Line :
City : TUCKER
State : GA
Zip : 30084-6901
Country : US
Telephone Number : 770-638-1400
Fax Number : 770-638-1411
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2007
Last Update Date : 10/07/2015

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