Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 255542 | MA |
NPI | 1013150309 |
---|---|
Provider Name | Ravi Krishna Murthy |
First Address | Somerville, MA 02145-2628 |
Second Address | Lowell, MA 01854-2134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2009 |
Last Update Date | 17/03/2018 |