Provider Demographics
NPI:1780612671
Name:MUTTAL, SARASWATI (MD)
Entity type:Individual
Prefix:DR
First Name:SARASWATI
Middle Name:
Last Name:MUTTAL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MARYLAND FARMS STE 200
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5005
Mailing Address - Country:US
Mailing Address - Phone:615-345-5400
Mailing Address - Fax:615-345-5405
Practice Address - Street 1:4612 MOTIF TER
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-2525
Practice Address - Country:US
Practice Address - Phone:800-348-4565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4408042084N0400X
GA727942084N0400X
MI43010779282084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT49299OtherSTATE LICENSE
FLME119782OtherFL STATE LICENSE