Provider Demographics
NPI:1811153489
Name:HUNDAL, MANDEEP (MD)
Entity type:Individual
Prefix:
First Name:MANDEEP
Middle Name:
Last Name:HUNDAL
Suffix:
Gender:M
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:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-0726
Mailing Address - Country:US
Mailing Address - Phone:774-420-2642
Mailing Address - Fax:774-420-2283
Practice Address - Street 1:100 HOSPITAL RD STE 2A
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2253
Practice Address - Country:US
Practice Address - Phone:978-466-2692
Practice Address - Fax:978-466-4754
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA247723208M00000X, 207R00000X, 207RP1001X
VT042-0011851208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine