Mudunuri, Lakshmi

Mudunuri, Lakshmi is an individual health care provider with primary practice located at 170 Governors Ave , Medford MA 02155-1643. She recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Psychiatry, which is considered as her primary health care specialty. Mudunuri, Lakshmi can be contacted via phone (781) 306-6163.

Contact Information

Primary practice address
170 Governors Ave Medford MA 02155-1643
Phone: (781) 306-6163
Fax: (781) 306-6146
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X 58025 Massachusetts

Profile Details

NPI number 1508847823
LBN Legal business name Mudunuri, Lakshmi
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2005
Last updated May 19th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508847823 NPPES
Massachusetts Other 15-80089 EVERCARE
Massachusetts Other J06711 EVERCARE
Massachusetts Other 058025 EVERCARE
Massachusetts MEDICAID 3027350 EVERCARE

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