Healthcare Provider Details

I. General information

NPI: 1477510238
Provider Name (Legal Business Name): MURTAZA E. NURBHAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

Provider Other Name: M. E. NURBHAI M.D., P.C.

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E 2ND ST
COUDERSPORT PA
16915-8161
US

IV. Provider business mailing address

1001 E 2ND ST
COUDERSPORT PA
16915-8161
US

V. Phone/Fax

Practice location:
  • Phone: 814-274-7761
  • Fax: 814-274-7753
Mailing address:
  • Phone: 814-274-7761
  • Fax: 814-274-7753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number019973E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: