Provider Demographics
NPI: | 1881659027 |
---|---|
Name: | MURAKAMI, NOBORU (MD) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | NOBORU |
Middle Name: | |
Last Name: | MURAKAMI |
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: | PO BOX 310 |
Mailing Address - Street 2: | |
Mailing Address - City: | LACONIA |
Mailing Address - State: | NH |
Mailing Address - Zip Code: | 03247-0310 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 603-524-3211 |
Mailing Address - Fax: | 603-527-7038 |
Practice Address - Street 1: | 15 AIKEN AVENUE |
Practice Address - Street 2: | |
Practice Address - City: | FRANKLIN |
Practice Address - State: | NH |
Practice Address - Zip Code: | 03235-1259 |
Practice Address - Country: | US |
Practice Address - Phone: | 603-934-5500 |
Practice Address - Fax: | 603-934-0333 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-04-19 |
Last Update Date: | 2011-09-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NH | NH4961 | 208600000X |
NH | 4961 | 174400000X, 208D00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | |
No | 174400000X | Other Service Providers | Specialist |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NH | 81023985 | Medicaid | |
NH | D78641 | Medicare UPIN | |
NH | 81023985 | Medicaid |