Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301098876 | MI |
N | 111NI0900X | Internist | 4301098876 | MI |
N | 207R00000X | Internist | E-6471 | AR |
N | 111NI0900X | Internist | E-6471 | AR |
Y | 207RX0202X | Medical Oncology | E-6471 | AR |
NPI | 1003080854 |
---|---|
Provider Name | Muthu Kumaran Veeraputhiran |
First Address | Little Rock, AR 72205-7101 |
Second Address | Little Rock, AR 72205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2008 |
Last Update Date | 14/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11101978 | DOB (01) | OK |
182720001 | (05) | AR |