Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 0101031786 | VA |
NPI | 1659302560 |
---|---|
Provider Name | Dr. Murali Dharan Sharath |
First Address | Virginia Beach, VA 23462-3873 |
Second Address | Virginia Beach, VA 23462-3873 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B60491 | (02) | VA |