Individual
ANNAMALAI MUTHIAH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 KINGSLEY LN, 305, NORFOLK, VA 23505-4614
(757) 889-5422
(757) 889-5450
Mailing address
110 KINGSLEY LN STE 305, NORFOLK, VA 23505-4617
(757) 889-5422
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101222615
VA
2085R0202X
Diagnostic Radiology Physician
Primary
0101222615
VA
2085R0202X
Diagnostic Radiology Physician
D0062747
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063407997
—
VA
05
—
407194800
—
MD
Enumeration date
09/16/2005
Last updated
09/06/2022
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