1902416969 NPI number — DR. CYNTHIA IRADUKUNDA MD

Table of content: DR. CYNTHIA IRADUKUNDA MD (NPI 1902416969)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902416969 NPI number — DR. CYNTHIA IRADUKUNDA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
IRADUKUNDA
Provider First Name:
CYNTHIA
Provider Middle Name:
Provider Name Prefix Text:
DR.
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:
1902416969
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DEPARTMENT OF ANESTHESIOLOGY, UW SCHOOL OF MEDICINE
Provider Second Line Business Mailing Address:
600 HIGHLAND AVE, B6/319
Provider Business Mailing Address City Name:
MADISON
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53705
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
608-263-8100
Provider Business Mailing Address Fax Number:
608-263-0575

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
489 STATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BANGOR
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04401-6674
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-275-0987
Provider Business Practice Location Address Fax Number:
207-275-4857
Provider Enumeration Date:
08/05/2020

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: 390200000X , with the licence number:  8403-851 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 390200000X , with the licence number: 77655-20 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: MD28603 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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