MEDICARE: MRS. SUMATHI KALIAPPAN MBBS

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
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1144562307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUMATHI KALIAPPAN MBBS

Provider Business Mailing Address
First Line	:	3627 POWELTON AVE
Second Line	:	APT 1F
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-2339
Country	:	US
Telephone Number	:	215-900-5720
Fax Number	:

Provider Business Practice Location Address
First Line	:	3627 POWELTON AVE
Second Line	:	APT 1F
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-2339
Country	:	US
Telephone Number	:	215-900-5720
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2013
Last Update Date	:	03/26/2013

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