Individual
MITHUNAN MAHESWARANATHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
169 ASHLEY AVE, ROOM 202 MAIN HOSPITAL, MSC 333, CHARLESTON, SC 29425-8905
(843) 792-0435
Mailing address
169 ASHLEY AVE, ROOM 202 MAIN HOSPITAL, MSC 333, CHARLESTON, SC 29425-8905
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
LL36884
SC
208000000X
Pediatrics Physician
LL36884
SC
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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