Provider Demographics
NPI:1114911989
Name:MURTHY, KUMBAIAH N (MD)
Entity Type:Individual
Prefix:DR
First Name:KUMBAIAH
Middle Name:N
Last Name:MURTHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N EUGENE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2221
Mailing Address - Country:US
Mailing Address - Phone:336-676-6840
Mailing Address - Fax:336-676-6490
Practice Address - Street 1:201 N EUGENE ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2221
Practice Address - Country:US
Practice Address - Phone:336-676-6840
Practice Address - Fax:336-676-6490
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC288852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC61647OtherBCBS NC
NCC81842Medicare UPIN
NC203412JMedicare ID - Type Unspecified