Provider Demographics
NPI:1003080854
Name:KUMARAN, MUTHU VEERA (MD)
Entity Type:Individual
Prefix:
First Name:MUTHU
Middle Name:VEERA
Last Name:KUMARAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MUTHU
Other - Middle Name:KUMARAN
Other - Last Name:VEERAPUTHIRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4301 W MARKHAM ST # 783
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4301 W MARKHAM ST # 556
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-686-6033
Practice Address - Fax:501-686-8932
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-6471207R00000X, 207RH0000X, 207RX0202X
MI4301098876207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR182720001Medicaid
OK11101978OtherDOB
AR182720001Medicaid