Provider Demographics
NPI:1871908871
Name:NANJANGUD SHIVAMURTHY, VEERESH KUMAR (MD,)
Entity type:Individual
Prefix:DR
First Name:VEERESH KUMAR
Middle Name:
Last Name:NANJANGUD SHIVAMURTHY
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 1:1000 ASYLUM AVE STE 4304
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-1704
Mailing Address - Country:US
Mailing Address - Phone:860-522-3711
Mailing Address - Fax:860-493-1885
Practice Address - Street 1:1000 ASYLUM AVE STE 2112
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-1719
Practice Address - Country:US
Practice Address - Phone:860-522-3711
Practice Address - Fax:860-493-1885
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-27
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT642182084N0600X, 273100000X, 2084E0001X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No273100000XHospital UnitsEpilepsy Unit
No2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy