Mundkur, Lata Tavanandi
Mundkur, Lata Tavanandi is an sole proprietor health care provider with primary practice located at 817 Merrimack St Second Floor, Lowell MA 01854-3571. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Mundkur, Lata Tavanandi can be contacted via phone (978) 452-0672.Contact Information
Primary practice address
817 Merrimack St Second Floor
Lowell MA 01854-3571
Phone: (978) 452-0672
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 58514 | Massachusetts |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 58514 | Massachusetts |
Profile Details
| NPI number | 1487645248 |
|---|---|
| LBN Legal business name | Mundkur, Lata Tavanandi |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 2nd, 2005 |
| Last updated | Aug 9th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487645248 | NPPES |
| Massachusetts | Other | 0466975 | AETNA US HEALTHCARE |
| Massachusetts | Other | 1487645248 | AETNA US HEALTHCARE |
| Massachusetts | Other | 4328196 | AETNA US HEALTHCARE |
| Massachusetts | Other | 970357 | AETNA US HEALTHCARE |
| Massachusetts | Other | J06028 | AETNA US HEALTHCARE |
| Massachusetts | Other | 0017292 | AETNA US HEALTHCARE |
| Massachusetts | Other | 043117888 | AETNA US HEALTHCARE |
| Massachusetts | Other | 058514 | AETNA US HEALTHCARE |
| Massachusetts | Other | 04-3117888 | AETNA US HEALTHCARE |
| Massachusetts | Other | 04-3117888 | AETNA US HEALTHCARE |
| Massachusetts | Other | 04-3117888 | AETNA US HEALTHCARE |
| Massachusetts | MEDICAID | 3015599 | AETNA US HEALTHCARE |
| Massachusetts | Other | 0401929 | AETNA US HEALTHCARE |
| Massachusetts | Other | 043117888 | AETNA US HEALTHCARE |
| Massachusetts | Other | 22D0943104 | AETNA US HEALTHCARE |
| Massachusetts | Other | 2449768 | AETNA US HEALTHCARE |
| Massachusetts | Other | 04-3117888 | AETNA US HEALTHCARE |
| Massachusetts | Other | 109517 | AETNA US HEALTHCARE |
| Massachusetts | Other | 33756 | AETNA US HEALTHCARE |
| Massachusetts | Other | 45819 | AETNA US HEALTHCARE |
| Massachusetts | Other | 65438 | AETNA US HEALTHCARE |
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