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1023404340
VIMUKTA MAHADEV
SEATTLE, WA
NPI
1023404340
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
208600000X Surgery
(Licence: WA MD61017974)
Enumeration Date
2015-04-14
Last Update Date
2021-10-05
Business Address
Mr. VIMUKTA MAHADEV M.D.
1959 NE PACIFIC ST BOX 356410
SEATTLE, WA 98195-6410
Phone number: 714-397-5742
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Mailing Address
Mr. VIMUKTA MAHADEV M.D.
1959 NE PACIFIC ST BOX 356410
SEATTLE, WA 98195-6410
Phone number: 714-397-5742
Copy
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