Provider Demographics
NPI:1972006088
Name:ADAVAN, ARUNMOZHI (MD)
Entity Type:Individual
Prefix:DR
First Name:ARUNMOZHI
Middle Name:
Last Name:ADAVAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ARUNMOZHI
Other - Middle Name:
Other - Last Name:PALANIVELU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:590 CHIEF TATAMY ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-7811
Mailing Address - Country:US
Mailing Address - Phone:385-775-2797
Mailing Address - Fax:
Practice Address - Street 1:5325 NORTHGATE DR STE 201
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-9413
Practice Address - Country:US
Practice Address - Phone:484-822-5630
Practice Address - Fax:833-932-1201
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD475143207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine