Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 29774 | MN |
Y | 207SG0201X | Clinical Genetics (M.D.) | ME151792 | FL |
NPI | 1316595531 |
---|---|
Provider Name | Karthik Muthusamy |
First Address | Jacksonville, FL 32224-1865 |
Second Address | Jacksonville, FL 32224-1865 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2019 |
Last Update Date | 17/09/2021 |