Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 0101266496 | VA |
NPI | 1154508968 |
---|---|
Provider Name | Dr. Mathula Thangarajh |
First Address | Richmond, VA 23291-1734 |
Second Address | Richmond, VA 23219-1930 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2008 |
Last Update Date | 01/10/2019 |