Individual
SUJIT REDDY MUTHUKURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-6665
(937) 395-6668
Mailing address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-8165
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35.134528
OH
208M00000X
Hospitalist Physician
Primary
35.143101
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0347626
—
OH
Enumeration date
07/01/2016
Last updated
05/05/2023
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