Provider Demographics
NPI:1275587297
Name:MURLI N MATHUR, M.D.
Entity Type:Organization
Organization Name:MURLI N MATHUR, M.D.
Other - Org Name:MURLI MATHUR, M.D. P.A.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MURLI
Authorized Official - Middle Name:N
Authorized Official - Last Name:MATHUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-877-8494
Mailing Address - Street 1:1305 FALLSTON RD
Mailing Address - Street 2:
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047-1621
Mailing Address - Country:US
Mailing Address - Phone:410-877-8494
Mailing Address - Fax:410-877-8494
Practice Address - Street 1:1305 FALLSTON RD
Practice Address - Street 2:
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047-1621
Practice Address - Country:US
Practice Address - Phone:410-877-8494
Practice Address - Fax:410-877-8494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0014155207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty