MEDICARE: EMERALD MEDICA PRACTICE PA

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	174400000X	Specialist

General Provider Information

NPI Number	:	1932906385
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMERALD MEDICA PRACTICE PA

Provider Business Mailing Address
First Line	:	1743 SIDEWINDER DR UNIT 114
Second Line	:
City	:	PARK CITY
State	:	UT
Zip	:	84060-7322
Country	:	US
Telephone Number	:	307-840-9834
Fax Number	:	833-450-0933

Provider Business Practice Location Address
First Line	:	1100 SW WANAMAKER RD STE 103
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66604-3805
Country	:	US
Telephone Number	:	307-840-9834
Fax Number	:	833-450-0933

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ASHWIN MURALIDHARAN
Credential	:
Telephone Number	:	307-840-9834

Provider Enumeration Date	:	02/25/2025
Last Update Date	:	06/19/2026

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Directions to “EMERALD MEDICA PRACTICE PA ” Practice Location

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