Individual
SUBBANA G MUTHUSWAMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2603 ELECTRIC AVE, #1, PORT HURON, MI 48060
(810) 987-5252
(810) 987-2120
Mailing address
2603 ELECTRIC AVE, #1, PORT HURON, MI 48060
(810) 987-5252
(810) 987-2120
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
4301033903
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2109010
—
MI
Enumeration date
12/12/2006
Last updated
07/08/2007
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