Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | 25MA10943000 | NJ |
N | 2086S0102X | Surgical Critical Care | MD039840 | DC |
Y | 2086S0120X | Pediatric Surgery | 25MA10943000 | NJ |
N | 2086S0120X | Pediatric Surgery | MD039840 | DC |
NPI | 1275856445 |
---|---|
Provider Name | Arunachalam Thenappan |
First Address | Baltimore, MD 21297-3215 |
Second Address | New Brunswick, NJ 08901-1962 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2010 |
Last Update Date | 16/10/2020 |