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NPI Code Detail

MEDICARE: MATTHEW JAMES MURTHA MEDICAL STIDENT

MEDICARE: MATTHEW JAMES MURTHA MEDICAL STIDENT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1477187466
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW JAMES MURTHA MEDICAL STIDENT
Provider Business Mailing Address
First Line : 370 W 9TH AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43210-1238
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 370 W 9TH AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43210-1238
Country : US
Telephone Number : 614-292-2220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2020
Last Update Date : 02/27/2020

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