Healthcare Provider Details

I. General information

NPI: 1467655191
Provider Name (Legal Business Name): PAPAIAH SRINIVASA MURTHY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 S STATE ST DEPT. OF ANESTHESIOLOGY
DOVER DE
19901-3530
US

IV. Provider business mailing address

2540 BAYVIEW AVE
VIRGINIA BEACH VA
23455-1373
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-4700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberC1-0008097
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: