Individual
MR. GAJAHNAN KUGAKUMARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
612 N 11TH ST, QUINCY, IL 62301-2662
(217) 224-9484
(217) 224-7950
Mailing address
612 N 11TH ST, QUINCY, IL 62301-2662
(217) 224-9484
(217) 224-7950
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125.084400
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/23/2024
Last updated
01/12/2026
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