Individual
MUTHUSAMI KUPPUSAMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
109 WINDSOR CIR, BLUEFIELD, VA 24605-9324
(276) 326-3356
Mailing address
109 WINDSOR CIR, BLUEFIELD, VA 24605-9324
(276) 326-3356
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
09769
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0124083000
—
WV
Enumeration date
04/13/2006
Last updated
07/08/2007
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