Provider Demographics
NPI:1629039904
Name:UTHAMALINGAM, SHANMUGAM (MD)
Entity Type:Individual
Prefix:
First Name:SHANMUGAM
Middle Name:
Last Name:UTHAMALINGAM
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 1:4501 MAGNOLIA COVE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-2252
Mailing Address - Country:US
Mailing Address - Phone:936-270-3933
Mailing Address - Fax:713-791-5134
Practice Address - Street 1:4501 MAGNOLIA COVE DR STE 201
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77345-2252
Practice Address - Country:US
Practice Address - Phone:936-270-3933
Practice Address - Fax:713-791-5134
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9528207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
1629039904OtherNPI
NHP00630805OtherRAILROAD MEDICARE
MA2150832Medicaid
NH30205432Medicaid
I15401Medicare UPIN
NHRE844302Medicare PIN
NHRE844301Medicare PIN