NPI 1104080639 · live from the CMS NPI Registry
Antony Leslie Innasimuthu, MD
Internal Medicine, Cardiovascular Disease in Newark, DE. National Provider Identifier 1104080639, active.
NPI record
| NPI | 1104080639 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine, Cardiovascular Disease 207RC0000X |
| Practice location | 620 Stanton Christiana Rd, Suite 203, Newark, DE 19713 |
| Practice phone | 302-338-9444 |
| Enumerated | July 14, 2008 |
| Last updated | February 26, 2020 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine, Interventional Cardiology | 207RI0011X | C1-0010967 (DE) |
| Nuclear Medicine, Nuclear Cardiology | 207UN0901X | C1-0010967 (DE) |
| Radiology, Vascular & Interventional Radiology | 2085R0204X | C1-0010967 (DE) |
| Clinic/Center, Medical Specialty | 261QM2500X | C1-0010967 (DE) |
| General Acute Care Hospital | 282N00000X | C1-0010967 (DE) |
| Internal Medicine, Cardiovascular Disease primary | 207RC0000X | C1-0010967 (DE) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.