UNKNOWN MALLIKARJUNAPPA (NPI# 1093996233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093996233 |
| Entity Type | Individual |
| Full Name | UNKNOWN MALLIKARJUNAPPA |
| Other Name | MALLIKARJUNAPPA MK |
| Credential | MD |
| Practice Address |
633 Gov Carlos Camacho Road Suite 210 Tamuning GU 96913 |
| Practice Telephone | 6716491001 |
| Mailing Telephone | 6716491001 |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2019-11-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
M-1858 | GU | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9200 West Wisconsin Avenue, Froedtert Memorial Lutheran Hospital, Milwaukee, WI 53226 | 4148053122 |
| Street Address |
633 GOV CARLOS CAMACHO ROAD SUITE 210 |
| City | TAMUNING |
| State | GU |
| Zip Code | 96913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154617835 | Peachy Mae Tadifa Piana-pacheco | Radiology | 633 Gov Carlos Camacho Road Suite 210, Tamuning, GU 96913 | 2011-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871126219 | Hannah Marie Sabo Laney | Behavior Technician | 212 Farenholt Ave., Tamuning, GU 96913 | 2020-02-13 |
| 1720618499 | Jacquelin Gouniai | Counselor | 121 North Sabana Drive Detcha Court, Barrigada Heights, GU 96913 | 2020-01-22 |
| 1205475753 | Gabriela Victoria Perez | Behavior Technician | 212 Farenholt Ave, Tamuning, GU 96913 | 2020-01-02 |
| 1073154944 | Quenie-mei Tuliao Fisher | Pharmacist | 790 Governor Carlos Camacho Rd, Tamuning, GU 96913 | 2019-10-02 |
| 1366090698 | Elizabeth Rabon | Technician | 251 Carnation Ave, Mangilao, GU 96913 | 2019-08-29 |
| 1467000299 | Yun Ming Lin | Pharmacist | 850 Gov. Carlos Camacho Street, Tamuning, GU 96913 | 2019-08-26 |
| 1902465354 | Anthony John Litwinchuk Jr. | Audiologist | Usnh Guam - Audiology Department, Bldg #50 Farenholt Ave, Agana Heights, GU 96913 | 2019-06-10 |
| 1124580600 | Khkn Corporation | Acupuncturist | 817 N Marine Corps Dr 109, Tamuning, GU 96913 | 2019-04-03 |
| 1700346541 | Amc Mental Health, LLC | Marriage & Family Therapist | 263 Vietnam Veterans Highway, Mangilao, GU 96913 | 2019-03-20 |
| 1295292365 | Jhaymie Lynn Salarzon Bejerana | Behavior Technician | Building 1350 #216, Upper Tumon, GU 96913 | 2019-02-26 |
| Find all providers in zip 96913 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366737405 | Sarah Elizabeth Bumps | Radiology | 825 Pale San Vitores Rd Apt 907, Tamuning, GU 96913-4088 | 2011-06-16 |
| 1053525170 | Eric William Spak | Radiology | 301 Frank H Cushing Way # 3a, Tamuning, GU 96913-4067 | 2007-05-09 |
| 1346245362 | Roberto Molina Martinez | Radiology | 633 Gov Carlos Camacho Rd, Guam Radiology - Suite 210, Tamuning, GU 96913 | 2005-06-16 |
| 1114365632 | Eythor Bjorgvinsson | Radiology | 633 Gov. Carlos Camacho Rd, Ste 210 Guam Medical Plaza, Tamuning, GU 96913-3195 | 2013-06-06 |
| 1154617835 | Peachy Mae Tadifa Piana-pacheco | Radiology | 633 Gov Carlos Camacho Road Suite 210, Tamuning, GU 96913 | 2011-06-22 |
| 1649430885 | Lmr LLC | Radiology | 241 Farenholt Ave, Tamuning, GU 96913 | 2008-06-11 |
| 1801055223 | Ashish Khandelwal | Radiology | 633 Governor Carlos Camacho Road, Suite 210, Tamuning, GU 96913 | 2008-06-02 |
| 1760696702 | Andrew David Graves | Radiology | 548 S Marine Corps Dr, Tamuning, GU 96913-3539 | 2007-05-09 |
| 1023230752 | Pacific Radiology Inc A Professional Corporation | Radiology | 388 Ypao Rd, Sda Radiology Department, Tamuning, GU 96913-3701 | 2007-05-03 |
| 1669692059 | Xavier Rajesh Packianathan | Radiology | 633 Gov Carlos Camacho Rd, Suite 210, Tamuning, GU 96913 | 2007-04-26 |
| Find all providers in TAMUNING | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.