Provider Demographics
NPI:1043367105
Name:MUTHUNAYAGAM, NEWTON PACKIARAJ (MD)
Entity Type:Individual
Prefix:
First Name:NEWTON
Middle Name:PACKIARAJ
Last Name:MUTHUNAYAGAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18780 BAGLEY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3304
Mailing Address - Country:US
Mailing Address - Phone:440-816-4546
Mailing Address - Fax:440-816-4549
Practice Address - Street 1:18780 BAGLEY RD STE 200
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3304
Practice Address - Country:US
Practice Address - Phone:440-816-4546
Practice Address - Fax:440-816-4549
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12805207R00000X
OH35-091569207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine