Individual ProviderAnudeep MukkamalaStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address800 Washington St, Boston, MA 02111(617) 636-1619PECOS EnrollmentBased on the most recent information from CMS, provider Anudeep Mukkamala does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1326430356Provider TypeIndividualFull NameMukkamala, AnudeepTitleDr.CredentialM.D.GenderMaleSole ProprietorNoEnumeration Date2/27/2015Last Updated7/6/2019Contact InformationPractice LocationPractice Address800 Washington St, Boston, MA 02111Phone(617) 636-1619Fax(617) 636-8215Mailing LocationMailing Address800 Washington St, Boston, MA 02111-1552PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer