Provider Demographics
NPI:1376657338
Name:MUMICK, GUNEET (MD)
Entity Type:Individual
Prefix:
First Name:GUNEET
Middle Name:
Last Name:MUMICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6622 N 91ST AVE
Mailing Address - Street 2:STE 220
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-2569
Mailing Address - Country:US
Mailing Address - Phone:602-997-0484
Mailing Address - Fax:602-224-3358
Practice Address - Street 1:21410 N 19TH AVE
Practice Address - Street 2:SUITE 131
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027
Practice Address - Country:US
Practice Address - Phone:602-997-0484
Practice Address - Fax:602-224-3358
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ35913207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ182389Medicaid
AZ129098Medicare PIN