Provider Demographics
NPI:1861495095
Name:ARUMUGHAM, PRADEEP SUBRAMONIAM (MD)
Entity type:Individual
Prefix:
First Name:PRADEEP
Middle Name:SUBRAMONIAM
Last Name:ARUMUGHAM
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 1:701 DOCTORS DRIVE
Mailing Address - Street 2:SUITE N
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-1584
Mailing Address - Country:US
Mailing Address - Phone:252-559-2200
Mailing Address - Fax:252-522-9778
Practice Address - Street 1:701 DOCTORS DRIVE
Practice Address - Street 2:SUITE N
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1584
Practice Address - Country:US
Practice Address - Phone:252-559-2200
Practice Address - Fax:252-522-9778
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200301089207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89135AFMedicaid
NCH94408Medicare UPIN
NC89135AFMedicaid