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General NPI Number Information
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NPI Number | 1164754248
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Entity Type | Individual
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Provider Name | BINDU MUTHU M.D
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Gender | Female
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Dates
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Enumeration Date | 02/01/2010
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Last Update Date | 12/12/2014
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Provider Practice Location Address
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Address Line | 8140 ASHTON AVE STE 212
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City | MANASSAS
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State | VA
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Zip | 20109-5701
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Country | US
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Telephone | 703-362-3114
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Fax |
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Provider Business Mailing Address
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Address Line | 1510 SNOWFLAKE CT
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City | HERNDON
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State | VA
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Zip | 20170-3933
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Country | US
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Telephone | 703-362-3114
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0101254133
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License Number State | VA
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