Provider Demographics
NPI:1750567103
Name:USHA KUNDU MD FACOG PA
Entity type:Organization
Organization Name:USHA KUNDU MD FACOG PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:USHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNDU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-476-9802
Mailing Address - Street 1:5500 N DAVIS HWY
Mailing Address - Street 2:SUITE 1 1
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2064
Mailing Address - Country:US
Mailing Address - Phone:850-476-9802
Mailing Address - Fax:850-476-9841
Practice Address - Street 1:5500 N DAVIS HWY
Practice Address - Street 2:SUITE 1
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2064
Practice Address - Country:US
Practice Address - Phone:850-476-9802
Practice Address - Fax:850-476-9841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38199207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL067079100Medicaid
FLAH716Medicare PIN
FL067079100Medicaid
FLD53320Medicare UPIN