Provider Demographics
NPI:1578819546
Name:MUNJAL, SUMEET (MD)
Entity Type:Individual
Prefix:DR
First Name:SUMEET
Middle Name:
Last Name:MUNJAL
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 1:239 MITYLENE PARK DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3547
Mailing Address - Country:US
Mailing Address - Phone:706-322-1486
Mailing Address - Fax:706-324-3419
Practice Address - Street 1:239 MITYLENE PARK DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3547
Practice Address - Country:US
Practice Address - Phone:334-603-6626
Practice Address - Fax:706-324-3419
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ALMD.35005207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL254675Medicaid