Provider Demographics
NPI:1023005030
Name:MUJUMDAR, ASHOK V (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:V
Last Name:MUJUMDAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2317 MOUNTAIN RUN
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244-1955
Mailing Address - Country:US
Mailing Address - Phone:205-988-4634
Mailing Address - Fax:
Practice Address - Street 1:1700 UNIVERSITY BLVD E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-2985
Practice Address - Country:US
Practice Address - Phone:205-554-4196
Practice Address - Fax:205-554-4196
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7941207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALH77224Medicare UPIN