MEDICARE: VICTORIA MURAD

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	363LP2300X	Primary Care Nurse Practitioner	4704330469	MI

General Provider Information

NPI Number	:	1669141362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA MURAD

Provider Business Mailing Address
First Line	:	5606 DRAKE HOLLOW DR W
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-1274
Country	:	US
Telephone Number	:	248-979-7920
Fax Number	:

Provider Business Practice Location Address
First Line	:	35614 DEQUINDRE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-4288
Country	:	US
Telephone Number	:	586-883-6787
Fax Number	:

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

Provider Enumeration Date	:	09/07/2021
Last Update Date	:	09/07/2021

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