Individual
NATARAJ SHANMUGAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
A115371
CA
2085R0202X
Diagnostic Radiology Physician
42869
AZ
2085R0202X
Diagnostic Radiology Physician
Primary
A115371
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
524526
—
AZ
01
—
A115371
MEDICAL LICENSE
CA
01
—
Z137927
MEDICARE PTAN FOR MDIG-YUMA
AZ
Enumeration date
07/14/2008
Last updated
02/11/2020
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