Individual
MURUGESAN MANIVASAGAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
500 UPPER CHESAPEAKE DR, BEL AIR, MD 21014-4324
(443) 643-1500
(443) 643-1505
Mailing address
2720 SUNNYSIDE LN, ELLICOTT CITY, MD 21043-3686
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
R184344
MD
363LA2100X
Acute Care Nurse Practitioner
Primary
R184344
MD
363LG0600X
Gerontology Nurse Practitioner
R184344
MD
Other
Enumeration date
12/16/2018
Last updated
02/17/2022
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