Provider Demographics
NPI:1770677437
Name:MURTHY, KODE (MD)
Entity Type:Individual
Prefix:
First Name:KODE
Middle Name:
Last Name:MURTHY
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 1:732 LILA AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-1609
Mailing Address - Country:US
Mailing Address - Phone:513-831-3000
Mailing Address - Fax:513-831-6664
Practice Address - Street 1:732 LILA AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1609
Practice Address - Country:US
Practice Address - Phone:513-831-3000
Practice Address - Fax:513-831-6664
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35. 0342962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0185197Medicaid
OHC00969Medicare UPIN