Provider Demographics
NPI:1720041148
Name:MURNANE, MICHAEL R (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:R
Last Name:MURNANE
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 1:5450 FRANTZ RD STE 360
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4141
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:765 N HAMILTON RD STE 120
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-8707
Practice Address - Country:US
Practice Address - Phone:614-533-5000
Practice Address - Fax:614-533-0101
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35048330M207RI0011X
OH35.048330207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH060005316OtherRAILROAD MEDICARE
060005316OtherRAILROAD MEDICARE
289254OtherBLACK LUNC
000000000014676OtherANTHEM BCBS
2500188OtherUNITED HEALTHCARE OF OHIO
1866109OtherCIGNA
1035OtherNATIONWIDE
1866109OtherCIGNA
1035OtherNATIONWIDE
1866109OtherCIGNA
289254OtherBLACK LUNC