| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MRINAL SHUKLA | 1912297557 | 2023-11-10 |
Mrinal Shukla [M] graduated in 2011 and primarily specializes in Vascular Surgery.
Mrinal Shukla is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1912297557. Registration indicates Mrinal Shukla is a provider of services with a specialization in Allopathic & Osteopathic Physicians, Surgery (Surgery: Vascular Surgery, ) (Specialist Network, ) (Surgery Vascular Surgery, Allopathic & Osteopathic Physicians) (Surgery, ) (Allopathic & Osteopathic Physicians, Surgery) (Surgery: Vascular Surgery, ) (Specialist Network, ) (Surgery Vascular Surgery, Allopathic & Osteopathic Physicians) (Surgery, )
| PECOS ID | 1355646159 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Dr. Mrinal Shukla M.D. |
| Practice Office Address | 2500 N STATE ST JACKSON, MS US |
| Practice Office Telephone | 6018152005 |
| Practice Office Fax | 6018150434 |
| Mailing Address | 504 CLINTON CENTER DR STE 4300 CLINTON, MS 390565610 US |
| Business Telephone | 6018152005 |
| Business Fax | 6018150434 |
| Code | Practice | License No State |
|---|---|---|
| 2086S0129X PRIMARY | Allopathic & Osteopathic Physicians Surgery Surgery: Vascular Surgery Specialist Network Surgery Vascular Surgery Allopathic & Osteopathic Physicians Surgery | 31345
MS |
| 2086S0129X | Allopathic & Osteopathic Physicians Surgery Surgery: Vascular Surgery Specialist Network Surgery Vascular Surgery Allopathic & Osteopathic Physicians Surgery | 080579
GA |