Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 35334 | OH |
NPI | 1023091055 |
---|---|
Provider Name | Venkatachalam Muthiah |
First Address | Centerville, OH 45459 |
Second Address | Dayton, OH 45408-1445 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2005 |
Last Update Date | 28/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000004921 | ANTHEM (01) | OH |
0543826 | (05) | OH |
310821503028 | CARE SOURCE (01) | |
3108215037C18 | UNITED MINE WORKERS (01) | |
3120003 | UHC (01) | OH |
390003611 | MEDICARE RAILROAD (01) | |
647579 | ATENA (01) | |
A76396 | (02) | |
D35334 | HUMANA (01) |