Provider Demographics
NPI:1962661967
Name:MUNGARA AND ASSOCIATES
Entity Type:Organization
Organization Name:MUNGARA AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHIJA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNGARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-427-6159
Mailing Address - Street 1:1743 LAURELWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-4743
Mailing Address - Country:US
Mailing Address - Phone:205-427-6159
Mailing Address - Fax:
Practice Address - Street 1:440B SAINT LUKES DR
Practice Address - Street 2:SUITE B
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7104
Practice Address - Country:US
Practice Address - Phone:334-356-8080
Practice Address - Fax:334-215-8999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL257232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty