| Doctor Name: | DR. SULABHA S. MUJUMDAR |
| NPI Number: | 1669553731 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 19968 |
| Business Practice Address: | 3601 Cumberland Ave Middlesboro, KY - 409652613 |
| Business Phone Number: | 6062483100 |
| Business Fax Number: | 6062484141 |
| Mailing Address: | 3601 West Cumberland Avenue, P.o. Box 1208 MIDDLESBORO |
| State: | KY |
| Postal Code: | 40965 |
| Phone Number: | 6062483100 |
| Fax Number: | 6062484141 |
| NPI Enumeration Date: | 10/17/2006 |
| NPI Last Update Date: | 08/02/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 19968 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |