1750376687 NPI number — DR. AMY DENISE MURNEN M.D.

Table of content: PRIYA JASMIN PATEL PHARMD (NPI 1124877295)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750376687 NPI number — DR. AMY DENISE MURNEN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURNEN
Provider First Name:
AMY
Provider Middle Name:
DENISE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750376687
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1330 COSHOCTON
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNT VERNON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43050
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-393-6585
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1451 YAUGER
Provider Second Line Business Practice Location Address:
STE 1E
Provider Business Practice Location Address City Name:
MOUNT VERNON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-397-2244
Provider Business Practice Location Address Fax Number:
740-397-2993
Provider Enumeration Date:
09/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  35069571 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0103991 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 7555048 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 194169 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000121813 . This is a "ANTHEM B/C B/S" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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