=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700806304
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. PUSHKALA MURALITHARAN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/20/2006
-----------------------------------------------------
Last Update Date | 01/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 253 PLEASANT ST
-----------------------------------------------------
City | CONCORD
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03301-7560
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-226-6113
-----------------------------------------------------
Fax | 603-640-1228
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 253 PLEASANT STREET
-----------------------------------------------------
City | CONCORD
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-226-6113
-----------------------------------------------------
Fax | 602-229-5009
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 10055
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------