Individual
MR. AVINASH KASHYAP VISWANATHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3132 OLD JACKSONVILLE RD, SUITE 150, SPRINGFIELD, IL 62704-7400
(217) 862-0741
(217) 862-0858
Mailing address
3132 OLD JACKSONVILLE RD, SUITE 150, SPRINGFIELD, IL 62704-7400
(217) 862-0741
(217) 862-0858
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036.133495
IL
207R00000X
Internal Medicine Physician
336.094733
IL
Other
Enumeration date
09/20/2010
Last updated
05/23/2014
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