Individual
MUTHAMILAN CHINNAIRUSAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1997 BARRETT CT, HENDERSON, KY 42420-2667
(270) 826-3538
(270) 827-2779
Mailing address
PO BOX 1079, HENDERSON, KY 42419-1079
(270) 827-0353
(270) 827-4966
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
41979
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000575930
ANTHEM BC BS
KY
05
—
7100053500
—
KY
Enumeration date
07/17/2008
Last updated
12/19/2008
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