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General NPI Number Information
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NPI Number | 1518287374
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Entity Type | Individual
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Provider Name | MATT MURAMOTO DO
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Gender | Male
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1001 NOBLE ST
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City | FAIRBANKS
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State | AK
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Zip | 99701-4948
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Country | US
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Telephone | 907-459-3500
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Fax | 907-459-3526
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Provider Business Mailing Address
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Address Line | 1001 NOBLE ST
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City | FAIRBANKS
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State | AK
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Zip | 99701-4948
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Country | US
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Telephone | 907-459-3500
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Fax | 907-459-3526
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 125231
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License Number State | AK
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