Provider Demographics
NPI:1669660502
Name:MUJOOMDAR, ANEIL A (MD)
Entity Type:Individual
Prefix:
First Name:ANEIL
Middle Name:A
Last Name:MUJOOMDAR
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 1:49 MARION ST
Mailing Address - Street 2:#8A
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-4409
Mailing Address - Country:US
Mailing Address - Phone:613-737-8899
Mailing Address - Fax:
Practice Address - Street 1:OTTAWA HOSPITAL - GENERAL CAMPUS
Practice Address - Street 2:501 SMYTH ROAD
Practice Address - City:OTTAWA
Practice Address - State:ON
Practice Address - Zip Code:K1H8L6
Practice Address - Country:CA
Practice Address - Phone:613-737-8899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA233884208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)