Mazumder, Mridul K
Mazumder, Mridul K is an individual health care provider with primary practice located at 1616 Physicians Dr , Tallahassee FL 32308-4619. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Mazumder, Mridul K can be contacted via phone (850) 431-5119.Contact Information
Primary practice address
1616 Physicians Dr
Tallahassee FL 32308-4619
Phone: (850) 431-5119
Fax: (850) 431-2467
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | ME129519 | Florida |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 27255 | South Carolina |
Profile Details
| NPI number | 1407902364 |
|---|---|
| LBN Legal business name | Mazumder, Mridul K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 25th, 2007 |
| Last updated | Feb 26th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407902364 | NPPES |
| South Carolina | MEDICAID | 272555 |
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