Individual provider · NPI-1

Dr. Alan Mundakkal, DO

Emergency Medicine · Hobart, IN

NPI number1679101075
StatusActive
Last updated in NPPESJul 27, 2023

Details

NPI
1679101075
Entity type
Individual (NPI-1)
Name
Dr. Alan Mundakkal
Credential
DO
Sex
Male
Sole proprietor
No
Enumeration date
Mar 31, 2020
Certification date
Jul 27, 2023
Last updated
Jul 27, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207P00000X Emergency Medicine02007186AINYes
207P00000X Emergency Medicine036165866IL
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

1500 S Lake Park Ave
Hobart, IN 46342-6699

Phone 219-942-0551

Mailing address

1500 S Lake Park Ave
Hobart, IN 46342-6699

Phone 219-947-6239 · Fax 419-291-2163

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