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Individual
PURUSHOTHAMAN MUTHUKANAGARAJ
Active
Individual
PURUSHOTHAMAN MUTHUKANAGARAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2016-01168
NC
2084P0800X
Psychiatry Physician
Primary
2016-01168
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083902399
—
NC
01
—
19LTG
BCBS OF NC
NC
Enumeration date
07/20/2011
Last updated
12/18/2024
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