Provider Demographics
NPI:1629236252
Name:SEVUGAN, ARUNACHALAM (MD)
Entity Type:Individual
Prefix:
First Name:ARUNACHALAM
Middle Name:
Last Name:SEVUGAN
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 1:11306 CORAL GABLES DR
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3803
Mailing Address - Country:US
Mailing Address - Phone:240-554-5112
Mailing Address - Fax:
Practice Address - Street 1:14205 PARK CENTER DR STE 201
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5252
Practice Address - Country:US
Practice Address - Phone:240-554-5112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0068012261QP2300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care