Individual
MUTHUKUMAR VELLAICHAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 SW 10TH AVE, TOPEKA, KS 66604-1301
(785) 354-5242
(785) 354-6349
Mailing address
1500 SW 10TH AVE, TOPEKA, KS 66604-1301
(785) 354-5242
(785) 354-6349
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
04-31957
KS
2080P0203X
Pediatric Critical Care Medicine Physician
31074
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105668
BCBS OF KANSAS
KS
05
—
200385860M
—
KS
01
—
KA2129034
MEDICARE PTAN
KS
Enumeration date
07/08/2006
Last updated
03/16/2018
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