Provider Demographics
NPI:1407894371
Name:MURRAY-PRASAD, CATRINA GRACE (MD)
Entity Type:Individual
Prefix:DR
First Name:CATRINA
Middle Name:GRACE
Last Name:MURRAY-PRASAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CATRINA
Other - Middle Name:GRACE
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5301 E HURON RIVER DRIVE
Mailing Address - Street 2:MC 69504
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1051
Mailing Address - Country:US
Mailing Address - Phone:734-827-8883
Mailing Address - Fax:574-239-8511
Practice Address - Street 1:36475 WEST FIVE MILE ROAD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154
Practice Address - Country:US
Practice Address - Phone:734-655-1000
Practice Address - Fax:574-239-8511
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01056235A174400000X, 207V00000X
MI4301072306207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200418280BMedicaid
INH76550Medicare UPIN
IN735850TMedicare ID - Type Unspecified