Provider Demographics
NPI:1558357053
Name:MURILLO, RENE TORRES (MD)
Entity Type:Individual
Prefix:DR
First Name:RENE
Middle Name:TORRES
Last Name:MURILLO
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 1:3400 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0147
Mailing Address - Country:US
Mailing Address - Phone:812-469-6800
Mailing Address - Fax:
Practice Address - Street 1:3400 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0147
Practice Address - Country:US
Practice Address - Phone:812-469-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01035143208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
INF35409Medicare UPIN
IN941740AMedicare ID - Type UnspecifiedMEDICARE B