Individual
DR. VENKATARAMAN MUNUSAMY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 SOMERSET ST, MILLINOCKET, ME 04462-1258
(207) 723-5161
(207) 723-3040
Mailing address
200 SOMERSET ST, MILLINOCKET, ME 04462-1258
(207) 723-5161
(207) 723-3040
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
018538
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102320000
—
ME
01
—
12136389
CAQH
ME
Enumeration date
07/31/2007
Last updated
08/10/2010
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