1881672046 NPI number — RITU MUNJAL MD

Table of content: RITU MUNJAL MD (NPI 1881672046)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881672046 NPI number — RITU MUNJAL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MUNJAL
Provider First Name:
RITU
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881672046
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/21/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3178
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CEDAR RAPIDS
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52406-3178
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-398-1583
Provider Business Mailing Address Fax Number:
319-399-2085

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
202 10TH STREET SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CEDAR RAPIDS
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52403-2404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-398-1545
Provider Business Practice Location Address Fax Number:
319-399-2039
Provider Enumeration Date:
01/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  36124 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0461038 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3461038 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: PO00253851 . This is a "RR MEDICARE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 4461038 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1461038 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2461038 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5461038 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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