Provider Demographics
NPI:1205227840
Name:NIRMALA MURUGAVEL MD LLC
Entity Type:Organization
Organization Name:NIRMALA MURUGAVEL MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRMALA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURUGAVEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-395-9353
Mailing Address - Street 1:425 SAND CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-1589
Mailing Address - Country:US
Mailing Address - Phone:219-395-9353
Mailing Address - Fax:219-395-9147
Practice Address - Street 1:425 SAND CREEK DR
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-1589
Practice Address - Country:US
Practice Address - Phone:219-395-9353
Practice Address - Fax:219-395-9147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01041303A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty