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NPI Code Detail

MEDICARE: NIRMALA SHANMUGAM MD

MEDICARE: NIRMALA SHANMUGAM MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology PhysicianME76143FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083678502
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIRMALA SHANMUGAM MD
Provider Business Mailing Address
First Line : PO BOX 740177
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33474-0177
Country : US
Telephone Number : 561-740-2900
Fax Number : 561-434-4618
Provider Business Practice Location Address
First Line : 6944 LAKE WORTH RD
Second Line : 2ND FLOOR
City : LAKE WORTH
State : FL
Zip : 33467-2948
Country : US
Telephone Number : 561-434-0060
Fax Number : 561-434-4618
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2006
Last Update Date : 03/07/2017

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Directions to “ NIRMALA SHANMUGAM MD” Practice Location

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