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Individual
DR. LATHA BALAMUNISWAMY
Active
Individual
DR. LATHA BALAMUNISWAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036087173
IL
207Q00000X
Family Medicine Physician
34452
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036087173
BCILLINOIS
—
05
—
036087173002
—
IL
05
—
0575423
—
IA
05
—
1336113992
—
IA
05
—
1575423
—
IA
01
—
80193932
RR MEDICARE
—
Enumeration date
02/13/2006
Last updated
02/05/2015
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