Healthcare Provider Details

I. General information

NPI: 1538279146
Provider Name (Legal Business Name): YELAMELI S MURTHY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 CEDAR VALLEY DR
CEDAR BLUFF VA
24609-0787
US

IV. Provider business mailing address

PO BOX 787
CEDAR BLUFF VA
24609-0787
US

V. Phone/Fax

Practice location:
  • Phone: 276-964-6764
  • Fax: 276-964-6765
Mailing address:
  • Phone: 276-964-6764
  • Fax: 276-964-6765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number0101023129
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: