Individual
MRS. DIVIYALAXMI MURUGANANDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0110006077
VA
363AM0700X
Medical Physician Assistant
Primary
0110006077
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110006077
LICENSE
VA
Enumeration date
02/02/2018
Last updated
11/27/2023
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