MEDICARE: DR. MURALI DHARAN SHARATH MD, FACP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207KA0200X	Allergy Physician	0101031786	VA

General Provider Information

NPI Number	:	1659302560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MURALI DHARAN SHARATH MD, FACP

Provider Business Mailing Address
First Line	:	4534 BONNEY RD
Second Line	:	SUITE B
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-3873
Country	:	US
Telephone Number	:	757-499-4101
Fax Number	:

Provider Business Practice Location Address
First Line	:	4534 BONNEY RD
Second Line	:	SUITE B
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-3873
Country	:	US
Telephone Number	:	757-499-4101
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	07/08/2007

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