1609627371 NPI number — DR. ANNAMARIA MUWONGE MD

Table of content: DR. ANNAMARIA MUWONGE MD (NPI 1609627371)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609627371 NPI number — DR. ANNAMARIA MUWONGE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MUWONGE
Provider First Name:
ANNAMARIA
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:
RUKUNDO
Provider Other First Name:
ANNAMARIA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1609627371
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
326 NICHOLS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FITCHBURG
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01420-1914
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-343-5270
Provider Business Mailing Address Fax Number:
978-343-5390

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
326 NICHOLS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FITCHBURG
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01420-1914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-343-5270
Provider Business Practice Location Address Fax Number:
978-343-5390
Provider Enumeration Date:
03/29/2024

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 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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