MEDICARE: DAKSHINA R MURTHY MD

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	207RC0000X	Cardiovascular Disease Physician	01049593A	IN
2	207RC0000X	Cardiovascular Disease Physician	29762	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801895016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAKSHINA R MURTHY MD

Provider Business Mailing Address
First Line	:	800 WHEELING AVE
Second Line	:
City	:	GLEN DALE
State	:	WV
Zip	:	26038-1660
Country	:	US
Telephone Number	:	304-845-0100
Fax Number	:	304-845-9879

Provider Business Practice Location Address
First Line	:	100 PADUCAH DR
Second Line	:
City	:	NEW MARTINSVILLE
State	:	WV
Zip	:	26155-2710
Country	:	US
Telephone Number	:	304-815-0050
Fax Number	:	304-815-0051

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	04/18/2022

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