Individual
DR. MANOHARAN MUTHUVELU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD MRCP FRCR MSC
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-0001
(570) 271-6301
(570) 271-5976
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD432405
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102092597
—
PA
Enumeration date
09/18/2007
Last updated
07/31/2020
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