Healthcare Provider Details

I. General information

NPI: 1396723870
Provider Name (Legal Business Name): SRILAKSHMI S MURTHY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 02/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 UNIVERSITY CT STE 3100 UNIVERSITY FAMILY PHYSICIANS-UNIVERSITY POINTE
WEST CHESTER OH
45069-6545
US

IV. Provider business mailing address

PO BOX 636256 CENTRAL CREDENTIALING
CINCINNATI OH
45263-6256
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8264
  • Fax: 513-475-8265
Mailing address:
  • Phone: 513-585-5501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35077487
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35-077487
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: