Individual
PRITI M NUTHAKKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
701 SUPERIOR AVE STE 2700, MUNSTER, IN 46321-4037
(219) 934-9813
(219) 934-9823
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01080501A
IN
207R00000X
Internal Medicine Physician
036082683
IL
207RG0100X
Gastroenterology Physician
Primary
01080501A
IN
207RG0100X
Gastroenterology Physician
036082683
IL
207RI0008X
Hepatology Physician
036082683
IL
207RT0003X
Transplant Hepatology Physician
01080501A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300015239
—
IN
Enumeration date
04/03/2009
Last updated
09/14/2023
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