MEDICARE: PRADEEP KUMAR MURTHAIAH MD

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
1	207Q00000X	Family Medicine Physician	01073487A	IN

General Provider Information

NPI Number	:	1609155811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRADEEP KUMAR MURTHAIAH MD

Provider Business Mailing Address
First Line	:	321 E NORTHFIELD DR STE 100
Second Line	:
City	:	BROWNSBURG
State	:	IN
Zip	:	46112-2415
Country	:	US
Telephone Number	:	317-852-6065
Fax Number	:	317-852-2468

Provider Business Practice Location Address
First Line	:	711 E 38TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-2748
Country	:	US
Telephone Number	:	463-249-2314
Fax Number	:	317-245-2388

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2011
Last Update Date	:	12/18/2023

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