Provider Demographics
NPI:1437109576
Name:MURTY, PREETHI V (MD)
Entity Type:Individual
Prefix:
First Name:PREETHI
Middle Name:V
Last Name:MURTY
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 1:1597 WASHINGTON PIKE STE A22
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-2878
Mailing Address - Country:US
Mailing Address - Phone:412-489-6919
Mailing Address - Fax:412-489-6279
Practice Address - Street 1:401 MARKET ST STE 902
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2867
Practice Address - Country:US
Practice Address - Phone:740-282-1624
Practice Address - Fax:740-283-1131
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD427415207R00000X
WV23523207RN0300X, 207RN0300X
OH35 083804207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP01027051OtherRR MEDICARE
OH2870979Medicaid
WV3000347000Medicaid
PA884567OtherMEDICARE
PAP01033240OtherRR MEDICARE
PA101463707Medicaid
WVWV0847AMedicare PIN
OH9285544Medicare PIN
WV4260271Medicare PIN
OH2870979Medicaid
PA101463707Medicaid
OHH051280Medicare PIN