Individual
DR. KADHIRESAN MURUGAPPAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD SC
Contact information
Practice address
611 S MARSHALL AVE, MC LEANSBORO, IL 62859-1213
(618) 643-2361
(618) 643-2361
Mailing address
PO BOX 429, MC LEANSBORO, IL 62859-0429
(618) 643-2361
(618) 643-2361
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036060687
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036060687
—
IL
01
—
DA7259
RAILROAD MEDICARE
GA
Enumeration date
09/19/2005
Last updated
10/19/2016
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