Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 35046455K | OH |
NPI | 1013991843 |
---|---|
Provider Name | Thiruvengadam Kulasekaran |
First Address | Akron, OH 44302-1821 |
Second Address | Akron, OH 44302-1821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2005 |
Last Update Date | 15/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0468533 | (05) | OH |
A80466 | (02) |