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Individual
SIMONE THAVASEELAN
Active
Individual
SIMONE THAVASEELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD13391
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659463230
GROUP NPI
—
01
—
349005986
MEDICARE GROUP PTAN
RI
Enumeration date
04/24/2007
Last updated
10/14/2011
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