Provider Demographics
NPI:1477510238
Name:NURBHAI, MURTAZA E (MD)
Entity Type:Individual
Prefix:
First Name:MURTAZA
Middle Name:E
Last Name:NURBHAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:M.
Other - Middle Name:E
Other - Last Name:NURBHAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PC
Mailing Address - Street 1:1001 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:COUDERSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:16915-8161
Mailing Address - Country:US
Mailing Address - Phone:814-274-7761
Mailing Address - Fax:814-274-7753
Practice Address - Street 1:1001 E 2ND ST
Practice Address - Street 2:
Practice Address - City:COUDERSPORT
Practice Address - State:PA
Practice Address - Zip Code:16915-8161
Practice Address - Country:US
Practice Address - Phone:814-274-7761
Practice Address - Fax:814-274-7753
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA019973E207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA063776OtherHIGHMARK BLUE SHIELD
PA0005873040002Medicaid
PAB34685Medicare UPIN
PA0005873040002Medicaid