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NPI Code Detail

MEDICARE: MUKTA PANDA MD

MEDICARE:   MUKTA  PANDA  MD
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
1207R00000XInternal Medicine PhysicianMD30541TN

General Provider Information

NPI Number : 1861486441
Entity Type Code : Individual
Provider Name (Legal Business Name) : MUKTA PANDA MD
Provider Business Mailing Address
First Line : 3905 HIXSON PIKE STE 103
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37415-3569
Country : US
Telephone Number : 423-756-1506
Fax Number : 423-756-1909
Provider Business Practice Location Address
First Line : 3905 HIXSON PIKE STE 103
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37415-3569
Country : US
Telephone Number : 423-756-1506
Fax Number : 423-756-1909
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2005
Last Update Date : 02/05/2026

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Directions to “ MUKTA PANDA MD” Practice Location

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