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General NPI Number Information
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NPI Number | 1871908871
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Entity Type | Individual
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Provider Name | VEERESH KUMAR NANJANGUD SHIVAMURTHY M.D.,
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Gender | Male
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Dates
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Enumeration Date | 06/27/2014
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | 1000 ASYLUM AVE STE 2112
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City | HARTFORD
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State | CT
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Zip | 06105-1719
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Country | US
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Telephone | 860-522-3711
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Fax | 860-493-1885
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Provider Business Mailing Address
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Address Line | 1000 ASYLUM AVE STE 4304
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City | HARTFORD
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State | CT
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Zip | 06105-1704
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Country | US
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Telephone | 860-522-3711
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Fax | 860-493-1885
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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 | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 64218
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 273100000X
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Taxonomy Name | Epilepsy Hospital Unit
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License Number | 64218
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 2084E0001X
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Taxonomy Name | Epilepsy Physician
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License Number | 64218
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 64218
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License Number State | CT
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