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1124092341
MESHACH VEDANAYAGAM SAMUEL
MARION, IL
NPI
1124092341
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IL 036-103980)
Enumeration Date
2006-02-14
Last Update Date
2016-12-01
Business Address
DR. MESHACH VEDANAYAGAM SAMUEL
2401 W MAIN ST
MARION, IL 62959-1188
Phone number: 618-997-5311
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Mailing Address
DR. MESHACH VEDANAYAGAM SAMUEL
14614 GOSSETT RD
WEST FRANKFORT, IL 62896-4219
Phone number: 618-937-6650
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