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NPI Code Detail

MEDICARE: DR. KADHIRESAN MURUGAPPAN MD SC

MEDICARE: DR. KADHIRESAN MURUGAPPAN MD SC
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
1207R00000XInternal Medicine Physician036060687IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DA7259OTHERGARAILROAD MEDICARE

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 : 1588659320
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KADHIRESAN MURUGAPPAN MD SC
Provider Business Mailing Address
First Line : PO BOX 429
Second Line :
City : MC LEANSBORO
State : IL
Zip : 62859-0429
Country : US
Telephone Number : 618-643-2361
Fax Number : 618-643-2361
Provider Business Practice Location Address
First Line : 611 S MARSHALL AVE
Second Line :
City : MC LEANSBORO
State : IL
Zip : 62859-1213
Country : US
Telephone Number : 618-643-2361
Fax Number : 618-643-2361
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2005
Last Update Date : 10/19/2016

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