Individual
DR. PASUPATHY PADMANABHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3375 N SEMINARY STREET, GALESBURG, IL 61401
(309) 343-7775
(309) 343-2726
Mailing address
PO BOX 9382, PEORIA, IL 61612-9382
(309) 691-4410
(309) 589-2830
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036051742
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036051742
—
IL
Enumeration date
07/04/2006
Last updated
03/13/2009
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