Provider Demographics
NPI:1346395100
Name:MAJMUDAR, MAULIK DILIPKUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:MAULIK
Middle Name:DILIPKUMAR
Last Name:MAJMUDAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:75 FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6110
Mailing Address - Country:US
Mailing Address - Phone:617-732-5000
Mailing Address - Fax:
Practice Address - Street 1:17875 VON KARMAN AVE STE 150&250
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6200
Practice Address - Country:US
Practice Address - Phone:888-604-0014
Practice Address - Fax:833-464-4177
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA238770207RC0000X
NC2008-01159207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2022523Medicare PIN