Provider Demographics
NPI:1740401413
Name:TUNUGUNTLA, RENUKA (MD)
Entity Type:Individual
Prefix:DR
First Name:RENUKA
Middle Name:
Last Name:TUNUGUNTLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RENUKA RAO
Other - Middle Name:
Other - Last Name:CHUNDURU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:121 ROUTE 31 STE 1000
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5755
Mailing Address - Country:US
Mailing Address - Phone:908-788-6373
Mailing Address - Fax:
Practice Address - Street 1:121 ROUTE 31 STE 1000
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5755
Practice Address - Country:US
Practice Address - Phone:908-788-6373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2020-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96918207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine