Provider Demographics
NPI:1245585322
Name:MURARI, PALLAVI (MD)
Entity Type:Individual
Prefix:DR
First Name:PALLAVI
Middle Name:
Last Name:MURARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61602-1076
Mailing Address - Country:US
Mailing Address - Phone:616-307-7220
Mailing Address - Fax:
Practice Address - Street 1:815 MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61602-1076
Practice Address - Country:US
Practice Address - Phone:616-307-7220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL037138082207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine