Provider Demographics
NPI:1720572936
Name:NACHIAPPAN, MUTHIAH
Entity Type:Individual
Prefix:
First Name:MUTHIAH
Middle Name:
Last Name:NACHIAPPAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 NW 12 AVENUE
Mailing Address - Street 2:DEPARTMENT OF NEURORADIOLOGY
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12605 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2545
Practice Address - Country:US
Practice Address - Phone:720-848-6617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2022-07-20
Deactivation Date:2019-01-25
Deactivation Code:
Reactivation Date:2019-02-01
Provider Licenses
StateLicense IDTaxonomies
CODR.00682912085N0904X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology