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Individual
DR. ASUNTA T. MODUTHAGAM
Active
Individual
DR. ASUNTA T. MODUTHAGAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.126803
IL
390200000X
Student in an Organized Health Care Education/Training Program
57-012886
OH
Other
Enumeration date
05/30/2007
Last updated
04/04/2012
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