Individual
THOMAS J NEDUMTHOTTATHIL
Active
Individual
THOMAS J NEDUMTHOTTATHIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA08034600
NJ
207R00000X
Internal Medicine Physician
Primary
42606
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1507217
—
TN
05
—
1516785
—
TN
01
—
4163983
BCBS
TN
01
—
4239941
BCBS
TN
01
—
42635
MEDICAID TLC
TN
Enumeration date
12/14/2006
Last updated
11/17/2010
Update your record
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