Mundodi, Balakrishna
Mundodi, Balakrishna is an individual health care provider with primary practice located at 350 John Deere Rd , Moline IL 61265-6899. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Mundodi, Balakrishna can be contacted via phone (309) 743-6700.Contact Information
Primary practice address
350 John Deere Rd
Moline IL 61265-6899
Phone: (309) 743-6700
Fax: (309) 764-2042
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036066456 | Illinois |
Profile Details
| NPI number | 1093794943 |
|---|---|
| LBN Legal business name | Mundodi, Balakrishna |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 10th, 2006 |
| Last updated | Jul 29th, 2013 - about 11 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 | 1093794943 | NPPES |
| Other | 060051143 | MEDICARE RAILROAD | |
| MEDICAID | 036066456 | MEDICARE RAILROAD | |
| MEDICAID | 1955849 | MEDICARE RAILROAD |
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