Organization Active NPI

Mundy Diagnostics PC

Doing business as Mundy Pain Clinic

  • Pain Medicine Physician
  • Flint, MI
National Provider Identifier
1013179738
Registry record updated Nov 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
MUNDY DIAGNOSTICS PC
Doing business as
Mundy Pain Clinic
Practice address
6240 Rashelle Dr
Suite 103
Flint, MI 48507-3934
Phone
(810) 232-9800
Fax
(810) 232-7710
NPI assigned
Jun 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ram Gunabalan, MD
Title
President
Phone
(810) 232-9800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

6240 Rashelle Dr
Suite 103
Flint, MI 48507-3934

Mailing address

6240 Rachelle Dr
Ste 103
Flint, MI 48507
Phone (810) 232-9800

Other identifiers 1

IdentifierTypeStateIssuer
700B501880OtherMIMI BCBS

Other names 1

  • Mundy Pain Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

6240 Rashelle Dr
Ste 103
Flint, MI 48507
Phone (810) 232-9800

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225843200000",
    "number": "1013179738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6240 RACHELLE DR",
            "address_2": "STE 103",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "48507",
            "telephone_number": "810-232-9800",
            "fax_number": "810-232-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6240 RASHELLE DR",
            "address_2": "SUITE 103",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073934",
            "telephone_number": "810-232-9800",
            "fax_number": "810-232-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNDY DIAGNOSTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-11-05",
        "status": "A",
        "authorized_official_last_name": "GUNABALAN",
        "authorized_official_first_name": "RAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-232-9800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI BCBS",
            "identifier": "700B501880",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mundy Pain Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.