Provider Demographics
NPI:1811095144
Name:MUKHERJEE, PUNAM (MD)
Entity type:Individual
Prefix:
First Name:PUNAM
Middle Name:
Last Name:MUKHERJEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9911 ROSEWOOD HILL CIR
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-1487
Mailing Address - Country:US
Mailing Address - Phone:703-759-5076
Mailing Address - Fax:
Practice Address - Street 1:VETERANS ADMINISTRATION MEDICAL CTR
Practice Address - Street 2:50 IRVING STREET
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422-0001
Practice Address - Country:US
Practice Address - Phone:202-745-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101045442207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology