Provider Demographics
NPI:1326132093
Name:MURTHI, NAGAPRASAD B (MD)
Entity Type:Individual
Prefix:DR
First Name:NAGAPRASAD
Middle Name:B
Last Name:MURTHI
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 1:122 LUAKAHA CIR
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-8286
Mailing Address - Country:US
Mailing Address - Phone:808-633-7662
Mailing Address - Fax:808-442-1406
Practice Address - Street 1:122 LUAKAHA CIR
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-8286
Practice Address - Country:US
Practice Address - Phone:808-633-7662
Practice Address - Fax:808-442-1406
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010386502084P0800X, 2084P0005X
HIMD-176392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0005XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurodevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2964098Medicaid
MIA78446Medicare UPIN