Provider Demographics
NPI:1619949955
Name:ARUMUGAM, PURANI (MD)
Entity Type:Individual
Prefix:
First Name:PURANI
Middle Name:
Last Name:ARUMUGAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-6176
Mailing Address - Country:US
Mailing Address - Phone:309-764-1133
Mailing Address - Fax:309-764-6769
Practice Address - Street 1:612 35TH AVE
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-6176
Practice Address - Country:US
Practice Address - Phone:309-764-1133
Practice Address - Fax:309-764-6769
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207VG0400X207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
08100354OtherILLINOIS BLUE SHIELD
99584OtherIOWA BLUE SHIELD
IL211485Medicare PIN
C45627Medicare UPIN