Provider Demographics
NPI:1518927037
Name:MURCKO, LAWRENCE G (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:G
Last Name:MURCKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3650 OLENTANGY RIVER RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3464
Mailing Address - Country:US
Mailing Address - Phone:614-538-0527
Mailing Address - Fax:614-538-0527
Practice Address - Street 1:3650 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 300
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3464
Practice Address - Country:US
Practice Address - Phone:614-538-0527
Practice Address - Fax:614-538-0527
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35042781207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0488735Medicaid
OHC03549Medicare UPIN
H008051Medicare PIN