Provider Demographics
NPI:1518166909
Name:NATESAN, ARUMUGAM (MD)
Entity Type:Individual
Prefix:
First Name:ARUMUGAM
Middle Name:
Last Name:NATESAN
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 1:11511 BARRINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-4249
Mailing Address - Country:US
Mailing Address - Phone:440-821-9399
Mailing Address - Fax:
Practice Address - Street 1:26800 AMHEARST CIR
Practice Address - Street 2:APT. 108
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7570
Practice Address - Country:US
Practice Address - Phone:440-821-9399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35041380207RG0100X
GA057905207RG0100X
ND9933207RG0100X
MO2005013503207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B95388Medicare UPIN