Individual
DR. MURUGAVEL M MUTHUSAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11050 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1739
(833) 724-8326
(260) 425-6845
Mailing address
4101 TECHNOLOGY AVE, NEW ALBANY, IN 47150-8548
(812) 941-4500
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
01040972A
IN
207RH0003X
Hematology & Oncology Physician
23416-875
WI
207RH0003X
Hematology & Oncology Physician
36148444
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100219024
—
WI
05
—
100361800
—
IN
01
—
5171410003
DMERC
—
01
—
5171410004
DMERC
—
01
—
5171410005
DMERC
IN
Enumeration date
03/10/2006
Last updated
01/02/2024
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