Healthcare Provider Details

I. General information

NPI: 1043834559
Provider Name (Legal Business Name): ADITYA MURALIDHARAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2020
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6160 KEMPSVILLE CIR STE 200B
NORFOLK VA
23502-3945
US

IV. Provider business mailing address

230 CLEARFIELD AVE STE 124
VIRGINIA BEACH VA
23462-1832
US

V. Phone/Fax

Practice location:
  • Phone: 757-321-3300
  • Fax: 757-321-3330
Mailing address:
  • Phone: 757-321-3300
  • Fax: 757-321-3330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4351046015
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberA200739
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number0101290507
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number0101290507
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: