MEDICARE: SUDHAGAR MUTHURAJAN

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1942411715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUDHAGAR MUTHURAJAN

Provider Business Mailing Address
First Line	:	40003 EAGLE DR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-1921
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	40003 EAGLE DR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-1921
Country	:	US
Telephone Number	:	248-342-0600
Fax Number	:

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

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	07/08/2007

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Directions to “ SUDHAGAR MUTHURAJAN ” Practice Location

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