Provider Demographics
NPI:1386845758
Name:KUNKLE, RAMA M (DO)
Entity Type:Individual
Prefix:DR
First Name:RAMA
Middle Name:M
Last Name:KUNKLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:9225 N 3RD STREET
Mailing Address - Street 2:300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2473
Mailing Address - Country:US
Mailing Address - Phone:602-445-0751
Mailing Address - Fax:602-424-8128
Practice Address - Street 1:9225 N 3RD STREET
Practice Address - Street 2:300
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2473
Practice Address - Country:US
Practice Address - Phone:602-445-0751
Practice Address - Fax:602-424-8128
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ4698207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ232229Medicaid
AZ232229-01Medicaid
AZ232229Medicaid
AZZ116256Medicare PIN
AZ232229-01Medicaid