Individual
DR. MARYANHTHU DO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
801 MACARTHUR BLVD STE 404, MUNSTER, IN 46321-2919
(219) 836-2995
Mailing address
11824 SOUTHWEST HWY, SUITE 100, PALOS HEIGHTS, IL 60463-1055
(708) 361-0222
(708) 361-4536
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
02005724A
IN
2084N0400X
Neurology Physician
036108812
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036108812
—
IL
Enumeration date
08/08/2006
Last updated
07/10/2019
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